Health Insurance Benefits

Health insurance services are designed to offer people financial protection against any sort of losses which can be caused due to accidents, injuries or any other type of health illness. Today, in the market place you can find a health insurance policy to almost all types of health related issues. People have certainly realized the benefits of these policies in quite a big way, at least in the recent times.

Some of these policies can be purchased in the form of an individual policy. This type of policy can provide coverage to an individual only. So, only the individual who has taken the policy can enjoy the insurance benefits. There are some other health insurance policies which can be purchased as group policy. With this policy the whole group of individuals can enjoy insurance benefits.

Generally, individual policies are more expensive than the group insurance policies. One of the most important reasons for this is, the administration costs that are associated with the these policies are less when compared to individual policies. Through unions, or associations, or employers the group health insurance policies are purchased. Normally, the association will be a part of the policy. So, they will select the policy with maximum insurance benefits for their employees.

Almost all of the current organizations, group health insurance policies are provided as incentives to all their employees. This trend became quite popular especially in the last few years, because of increase of competition for talented and trained work force in the market place. Group and individual insurance plans have become an integral part of the HR activities. Now, the employees are feeling it as their right to get insurance benefits. They are no more treating it as a benefit or an incentive that they are getting from the organization.

These can provide a lot of insurance benefits. Just for an example, it may pay for the cost of hospitalization or surgery. At the same time it may also pay other hospital expenses such as the cost of the hospital room. How ever all group health insurance policies are not same in these aspects as some pay a flat rate daily for the cost of a room. So, as an employer you should take care of all these minute details while going for a good health insurance policy, if you are committed to provide maximum insurance benefits to your employees.

Minimum Insurance Benefit

Many reform advocates have claimed that the federal government should mandate a package of insurance benefits that all private and public health insurers would be legally compelled to provide. Switzerland is one country in which the government defines a what the insurance benefit will be for all standard health insurers. The National Coalition on Health Care also proposes “…requiring insurers to establish explicitly separate premiums for the core benefit package.” Is having the federal or state government mandate a minimum benefit package a good idea?

Cons

Most neo-classical economists would say that having the government mandate an insurance package is a bad idea. Regulation restricts choice. If consumers would prefer an insurance company to cover mental illness and another person would prefer their insurance company have more generous coverage for cancer treatment, then it would be welfare destroying to eliminate the individual’s choice. Even if regulators were able to determine an ‘optimal’ benefit package–even a benefit package deemed optimal for society is unlikely to be optimal for each individual–this optimality could only be achieved in a static setting. When new medical technologies and procedures became available would they be adopted? Adopting unproven medical technologies may not increase quality of care, but would increase the cost of premiums. Adopting technologies too late will harm the sick patients who could benefit from these advances.

Another issue is who would be deciding which procedures are included. Whether it is Congress or a medical “Federal Reserve,” these groups would be influenced by lobbying from the AMA, pharmaceutical companies, and patient interest groups. Further, Congressmen will have their own favorite diseases that they will include in the basic coverage plan, even when funding coverage for these diseases may not be as beneficial as for other diseases.

Pros

One benefit of the standardized medical package is that people would better be able to comparison shop. Currently, it is nearly impossible to determine what your insurance company covers unless you are an expert. With a mandated core benefit package, insurance companies would only be able to compete on the dimensions of price, service, and reputation. They would be no competition with regards to which procedures were covered. Also, this would help to attenuate the problem of adverse selection. Many insurers currently do not offer generous coverage since they know by doing so, they will attract the sickest individuals and likely decrease their profits.

Further with a standard benefit package there should be lower legal costs for both the insurance companies and patients. With a clear core benefit package, litigation would not be eliminated but it would certainly be curtailed since much of the payment ambiguity would be cleared up.

Supplemental Insurance

Regardless of whether or not you prefer a minimum insurance benefit, the government should allow supplementary insurance markets to exist. In this way, those who prefer more generous coverage could purchase additional insurance. Further, it is likely that supplemental insurance would be the first-adopters of new technology and could provide a testing group as to whether or not a new medical treatment should eventually be included into the core benefit package.

Whole Life Insurance Benefit

Details of each whole life insurance benefit will be listed and explained here on this page but first let us get an overview of what whole life insurance is about. Whole life insurance is permanent life insurance that maintains a level premium and a level face amount for as long as you keep your policy...even if it is to age 100. That is why it is referred to as permanent life insurance as compared to term life insurance which is kept in force for a specific period of years.

• Cash Values

  A prime whole life insurance benefit is the cash value contained in the policy. Although the premiums are higher than term insurance premiums these cash values tend to offset the extra premium over time. In many a case the total cash value plus the dividend...if any is earned...at the end of 15 or 20 years will return all premiums paid if the owner of the policy should decide to terminate the policy at that time. Dividends, however, are not guaranteed but are based on the investment and expense experience of the life insurance company.

  The policy owner can take loans from the cash values of their policies. They should, however, be repaid because if they are not the death benefit of the policy will be reduced by the amount owed plus any outstanding interest.

• Death Benefit

  An important whole life insurance benefit is the death benefit. This is what life insurance is all about...isn't it? The policy proceeds can be paid to the beneficiary either in one lump sum...the usual method of payment...or the beneficiary may elect to have it paid in the form of a monthly income. There are several income options to choose from.

• Policy Riders

  Another great benefit of owning a whole life insurance policy is that you can add several different riders to your whole life insurance policy. You can add various types of term policies to enhance your death benefit. Some companies even allow you to add these term riders on different members of your family. For example, you may choose to add a $50,000 term rider on your wife and a $10,000 term rider on each of your children. These certainly are great whole life insurance benefits...don't you think?

  Another whole life insurance benefit is the waiver of premium rider. You add this rider at a very low cost. Also available is the accidental death benefit rider otherwise known as the double indemnity rider. This is certainly another whole life insurance benefit.

There are considerably more benefits to the whole life insurance policy. Get an illustration and examine more of them.

Health Insurance Benefits Laws

Once you're done comparing health insurance quotes and plans and you've settled on employer-based health insurance, it's good to keep in mind the Department of Labor's Employee Benefits Security Administration (EBSA) administers a number of laws that cover these health insurance plans.

Here is a list of some of the laws affecting health insurance :

1) The Employee Retirement Income Security Act - This law protects people in retirement, health and other benefit plans through private employers by providing rights to information and a grievance and appeals process for private employer health insurance participants.

2) The Consolidated Omnibus Budget Reconciliation Act - This law only applies to special instances, but if you qualify as a former employee, retiree, spouse or dependent child you can purchase a temporary continuation of health insurance at group rates.

3) The Health Insurance Portability and Accountability Act - This law applies to working Americans and families with preexisting medical conditions. Through this act there is a guarantee of individual health insurance policies for eligible people and it prohibits discrimination in health care coverage.

4) The Newborns' and Mothers' Health Protection Act - Just as it sounds, this law offers rules on minimum health insurance coverage on how long the mother and child can stay in the hospital after childbirth.

5) Mental Health Parity Act - This law ensures mental health is given as much emphasis as physical health by requiring annual, or lifetime, limits on mental health benefits to be no lower than limits for medical and surgical benefits provided by a group health insurance plan.

6) Women's Health and Cancer Rights Act - Breast cancer is a frightening diagnosis and treatment runs a wide range of intensity and invasiveness. This law protects breast cancer patients who want to have a breast reconstruction after a mastectomy.

7) Mental Health Parity Act - This law ensures mental health is given as much emphasis as physical health by requiring annual, or lifetime, limits on mental health benefits to be no lower than limits for medical and surgical benefits provided by a group health insurance plan.

When you are part of an employer - based health insurance plan the Department of Labor’s Employee Benefits Security Administration is a great source of information on subjects such as your rights to information on how your plan works, how to quality benefits available in your plan and how to make claims on your health insurance plan.

Remember EBSA administers these laws that help protect your health insurance when you lose coverage, change jobs or if you suffer from certain special medical conditions. Also remember when choosing employer-based plans to carefully compare your health insurance options to make sure your plan works best for you and your family's medical needs.

Type of Life Insurance Benefits

Since I am an insurance agent myself, it is my job to always ensure my clients are all well protected. I will try to put it in a simple form so that you will know what can be insured in a life insurance policy. There are 5 major benefits:

1. Accidental Care
This is usually a rider attached to a main policy. It covers permanent disability, and death caused by accidents only. Accidents include car accident, fall down, etc. Normally it pays double the amount of sum assured if accidental death happens at a public conveyance (bus, passenger airplanes,LRT)
Adequate coverage: 5 times annual income
It is cheaper to get this accidental policy as a standalone plan from General Insurance companies.
Some people only have this type of policy. I always laugh at them. They never realize that they actually go to war with underwear only, no armour, no helmet, no nothing!

2. Hospitalization and Surgical Benefit (known as medical card or health card)
This benefits can cover all or most if not all of your medical expenses at hospital.
Adequate coverage: >RM150/day room and board benefit. Yearly limit of >RM50,000. Lifetime limit of >RM150,000.
Health card is not a credit card and it does not have money in it! If it is genuine cases, there will be not much trouble to get the Letter of Guarantee from the insurer when you are hospitalized. However, insurance company have the right to investigate before they pay out the claim.
3. 36 Critical Illnesses (Cancer, Stroke, Heart Attack etc)
It is different from the health card. This benefit is paid in a lump sum to our account, but not to the hospital. The purpose of this benefit is to replace out potential income loss when we take long leave for medical care.
Adequate coverage: 3 times annual income.

4. Total Permanent Disability (TPD)
TPD is a very severe case. After a person becomes TPD, it can be defined that he lost his ability to earn a living. There are 2 forms of benefit for TPD:
a) Lump Sum - this benefit is normally included when you purchase the policy for 36 Critical Illnesses.
b) Annuity - This is a separate rider which will pay you a yearly benefit. It is advisable to get the protection up to our annual income. However there is a maximum cap of RM50,000 per year per life assured per insurance company. If your income is more than that, you can consider to buy different policy from different insurer to get yourself fully covered.

5. Natural Death
No matter how you die, they will still pay your family this death benefit, except committing suicide within the 1st year. Since the life assured can’t enjoy this benefit, it is up to the individual commitment to their dependants to calculate how much coverage they should get. For instance, a father whose wife is taking care of his 1 year old son full time, it is advisable to be insured for at least the expenses of the family for up to 25 years.

Insurance Benefits

Insurance Benefits encompass the facilities associated with buying of insurances. Insurance is mainly a instrument used by consumers for hedging the future contingent risks related with life, health and non-life general issues. Insurance benefits help the policy holder or beneficiary in combating with the losses or hazards associated with him/her.

The policy holder buys the insurance to hedge against the future perceived losses by paying a regular amount to he insurance company known as the Premium. Insurance companies ensure financial reimbursement of the insured losses to the policy holders or his/her beneficiary. This is the most coveted Insurance Benefits.

But with time, more and more insurance companies have cropped up and consequently the competition among them has increased. Every company is trying to woo all the customers into its fold and in a way offering more and more innovative Insurance Benefits to the consumers.

• Affordability of Insurance
  The foremost insurance benefit in todays world is the low insurance rate and premium one has to pay. While choosing a insurance policy, every customer looks at this rate first and then to the other associated benefits. The lesser the insurance rate, the more affordable the insurance becomes. Thus, among all the insurance benefits, low insurance rate and premium is the most coveted one.
  
  
• Accessibility Of Insurance
  The easy accessibility of a insurance is the next most coveted Insurance Benefits that the customers look for. The online access to insurance companies and their policies has made them more lucrative to the customers. Now-a-days, customers can search, compare and select their insurance coverage through the click of a mouse from their own residence. This has been observed that through online services, the insurance companies have been able to reach more number of customers and consequently their customer base has also mopped up significantly.
  
  
• Some of the other Insurance Benefits are :-
  • Basic benefits of the insurance policy. That is, the person enrolling for the policy is entitled to receive the financial compensation in case of actual occurrence of the loss/hazard/damage.
    
    
  • Optional Insurance Benefits are also given by the companies to their policy holders in order to entice them to access their insurance package. These optional benefits include
    
    • health and dental insurance of the family, life insurance of the spouse and the child,
    • accidental death policy for the policy holder in addition to the actual insurance for which he/she has enrolled for,
    • long term and short term insurance plans against disability of the policy holder
    • unit linked insurance schemes meant for appreciation of the accumulated capital during the life span of the same, managed by an experienced and well-learned fund manager
    
    
    
  • Pre-tax insurance benefits
    These benefits are an added advantage to the insurance holders because they help them in saving a large portion of their tax payment. When the tax-payment gets curtailed then consequently their disposable income increases leading to more enjoyment out of a secured life.