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I. HEALTH INSURANCE
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GROUP & INDIVIDUAL PLANS |
We, as your broker, bring the knowledge and expertise of working with a large number of insurance companies. Whether you are interested in an individual or group health plan, we will provide you with innovative ideas about healthcare. We have a revolutionary vision of putting individuals and companies in control of their healthcare through the careful selection of quality, affordable and flexible health plans. |
UNDERSTANDING HEALTH INSURANCE
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No single plan will cover all costs associated with medical care, but some cover more than others. The following information will help explain differences between plans. |
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Types of Coverage
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1. Fee-for-Service (Indemnity) Plans
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With this traditional plan, you can make an appointment with almost any medical provider. You or your provider then sends your claim to the insurance company. If you have met your deductible for the year, then the Fee-for-Service plan will pay a percentage of the bill - usually 80% You pay 20%, known as coinsurance.
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2. Managed Care
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These health insurance plans provide health care services at a lower cost. However, members must adhere to certain rules designed to lower the cost of medical care.
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Types of Managed Care
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1. Health Maintenance Organizations (HMO)
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With an HMO, you receive health benefits for a set fee. Generally, there are no deductibles, but most plans require small copay per office visit. You must choose a primary care physician from the plan's list. Should you require seeing a specialist, your primary care physician will refer you to one within the HMO network.
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2. Preferred Provider Organization (PPO)
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This is not an HMO, but is another type of managed care. In this system, you may seek treatment from an approved network of providers, or may see other providers outside the network. You'll pay small copay and satisfy a deductible before benefits are paid. Then you'll pay a set coinsurance amount, which will be less expensive when you visit one of the providers in the plan's list versus one that is out of the network.
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3. Point of Service (POS)
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A hybrid of the HMO and PPO. Like an HMO, your primary care doctor makes referrals to other providers within the plan. But if you see a physician outside the network without consulting your primary care doctor, the POS plan will pay a predetermined amount of the bill and your share of the bill will be higher than it would if you stay in the network. |
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COMMON TERMS & DEFINITIONS USED IN HEALTH INSURANCE
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- Coinsurance
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A specified percentage of the cost of treatment of the insured is required to pay for all covered medical expenses remaining after the deductible ha s been met.
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- Copay
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A fixed dollar amount you pay at the time services are rendered. Typical copays are for office visits, prescriptions, or hospitalization.
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- Deductible
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The portion of your health care that you pay before insurance starts covering it. Typically, the higher the deductible, the lower the premiums.
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- Disability income insurance
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This plan will provide you with an income should you become unable to work due to an injury or illness. Benefits are usually 60% of your income at the time of disability.
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- Long-term care policies
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These cover medical care, nursing care and certain in-home care if you ever become unable to care for yourself due to an extended illness or disability.
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- Pre-existing condition
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An illness, disease or condition an individual has at the time of enrollment in a health care plan. Pregnancy is not a preexisting condition.
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II. WORKERS COMPENSATION INSURANCE
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In California, all firms are subject to Workers Compensation statute and all are required to carry Workers Comp insurance. There are no exceptions with regard to employees however; coverage is elective for working members of a partnership. |
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III. DIRECTORS & OFFICERS COVERAGE
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The basic coverage in D&O insurance is protection for the organization and the directors and officers against lawsuits brought by members, employees or third parties. The primary difference between general liability and D&O insurance is in the type of injury or loss covered. General liability covers actions alleging bodily injury or damage to property but excludes actions arising exclusively from a financial loss. D&O covers financial type losses but excludes actions arising from bodily injury or property damage. |
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IV. LIFE INSURANCE
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Deciding on the right type of life insurance plan requires expertise and knowledge. Life insurance policies are designed with different needs in mind, whether you are looking for temporary protection or cash accumulation. With the proper guidance and analysis of your specific needs, you will be assured to make the right decision. |
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PERMANENT LIFE INSURANCE |
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Permanent insurance is intended to stay in force your entire life. |
TERM LIFE INSURANCE |
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This policy is generally purchased for a set number of years. There is no buildup of cash value so the premiums are less than for permanent insurance. |
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AUTOMOBILE INSURANCE |
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There are two basic types of coverage. One involves damage to property and the other involves injury to a person(s). Drivers must, by law, be able to pay for losses they cause to others while operating a vehicle. Call us for a quote. |
HOMEOWNERS INSURANCE |
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A Homeowners insurance policy provides coverage for your dwelling, your personal property and your legal responsibility for damages to others.
Also offered are Renter's and Condominium/Townhouse Owners policies.
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EARTHQUAKE INSURANCE |
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An earthquake can be financially devastating to a homeowner. And although earthquakes are a real and present danger for Californians, they are typically not covered by homeowners insurance. Earthquake Insurance is written through the California Earthquake Authority. |
FLOOD INSURANCE |
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Offered through the National Flood Insurance Program (NFIP). For more information, a quote or to determine if you are in a flood zone, please give us a call. |
UMBRELLA INSURANCE |
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If you accidentally injure someone or damage their property, you could be sued. Even though your underlying policies such as auto and homeowners may provide substantial liability limits, it is possible that damages awarded exceed those limits. An umbrella policy provides coverage for unknown or unexpected exposures as well as legal costs. |
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