Informed Decisions

11/14/2025

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Check out Lou Pimber’s video.

11/07/2025

Aetna Medicare Advantage plans take a total approach to health. We have plans that include prescription drug coverage and additional benefits with plan premiums starting as low as $0.

11/07/2025

To allow your employees to make pre-tax contributions to their individual Health Savings Accounts through payroll deductions, you must offer the Health Savings Account option through a Section 125 cafeteria plan. This offers additional tax benefits for both you and your employees.

4. Provide employees with an High Deductible Health Plan.

11/07/2025

It is highly recommended that a company of your size use a

a.

Third Party Administrator to handle the complex administrative duties of a self-insured plan, which include:

i. Managing claims-The Third Party Administrator processes and pays claims from a dedicated trust or bank account that you fund.
ii. Ensuring compliance- The Third Party Administrator helps you navigate complex federal regulations, including the Employee Retirement Income Security Act (ERISA), the Affordable Care Act (ACA), and health insurance portability and privacy act (HIPPA).
iii. Providing network access-The Third Party Administrator provides access to a network of healthcare providers and negotiates rates on your behalf.
iv. Handling documentation- The Third Party Administrator assists with all required reporting to the Internal revenue service (IRS), such as filing Forms 1094-B and 1095-B.

2. Even with a solid understanding of administration, a small business has less financial capacity to absorb the risk of large, unpredictable claims. Stop-loss insurance protects your company from catastrophic claims that exceed a pre-determined amount for any single employee.

11/07/2025

For Designing Systems to legally operate a self-insured High Deductible Health Plan that is compatible with Health Savings Accounts;

a.

You must do the following:

i. Hire a third-party administrator (TPA)

11/07/2025

At the end of the day, your best friend, neighbor, or whoever you are talking to about your healthcare does NOT have the level of experience nor are they legally liable for the advice that they provide, where a licensed agent is.

11/07/2025

If you use network providers and the treatment you receive is covered by Medicare, (meaning not cosmetic or experimental) then Advantage plans can save you money. Someone who is severely ill has had hundreds of thousands of dollars in claims and their share of these bills has been minimal.

11/07/2025

A licensed agent is going to ask you multiple questions and do a needs assessment to try and whittle the 50+ options that are available down to a select few, then discuss with you each of those 2-4 options for you to make an educated decision on this very personal choice.

11/07/2025

If you have had any kind of insurance in the last 30 years, you are used to using networks of providers and how managed care works. These networks have drastically grown in the last 5-10 years!

11/07/2025

Let me shed some light on this as I have been educating on these things for few years.

a. Licensed agents MUST:

i. Take an annual test, pass with a 90% or higher plus 2-4 hours PER CARRIER of additional training to make sure to understand the upcoming product and regulatory changes EVERY YEAR.

ii. The insurance carriers like Anthem, Aetna, Humana, United Health Care pay the agent, not you. And, the government tells them what they are allowed to pay. It is the same regardless of which Advantage plan you choose.

11/07/2025

There’s so much confusion about are Advantage plans good or bad? Should you use a licensed agent or are they just out to take money and hurt you?

11/07/2025

You typically receive your Evidence of Coverage annually, and it becomes available in September for the following year. If you have any questions or need to access your Evidence of Coverage, you can usually find it on your insurance provider’s website or contact their customer service for assistance.