Health Insurance Plans for Businesses
02/11/2010
Standard Insurance Company (“The Standard”) recently signed a partnership agreement with Health Advocate, one of the leading health advocacy and assistance companies, in a bid to simplify healthcare plans and services. The Standard, a subsidiary of StanCorp Financial Group, Inc., announced today its new offering—the Health Advocacy Solution—in collaboration with Personal Health Advocates.Luce Giroux, Second Vice President of Product Management at The Standard, said that the Health Advocacy Solution would help increase worker productivity by reducing the employees’ stress in navigating the healthcare system. “The Health Advocacy Solution offers direct access to our Personal Health Advocates who will provide more efficient ways of solving healthcare-related issues.” Giroux said the Health Advocates are mostly nurses or well-trained assistants who will help workers navigate the usually complex healthcare system. They will help locate doctors, explain and clarify billing statements and negotiate fees, explain benefits plans and healthcare-related terminology, and even give assistance on issues related to prescription drugs. Moreover, the Health Advocates, backed by medical doctors and other health experts, also extend their help to their client’s spouse, parents, parents-in-law, and dependent children. Regardless of industry, groups with at least 10 employees can avail themselves of the Health Advocacy Solution at a discounted rate, in addition to The Standard’s other health insurance plans and services. David Rocchino, Chief Sales Officer of Health Advocate, Inc., also expressed his gratitude for The Standard’s partnership with his company. “We are indeed very pleased to be part of The Standard’s offering. Our advocacy complements their services and programs… This new service can help clients save time and money,” he added. Author: Van Kelsey
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02/11/2010
For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs. Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums. Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market. Author: Mark Kelsey
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01/30/2010
The rising cost of health insurance prevents employers from availing
this benefit for their employees. Despite the fact that it can attract many
applications from the brightest and the best in the industry, it can require a
very large budget from a company.
The health insurance cost is the main obstacle in providing the
workforce a health plan. However, there are many options available where people
can obtain health insurance plans that are affordable. One option is by creating
or joining a health insurance co-op to reduce the costs of the total health
plan package. Small businesses employ this type of health insurance to achieve
a win-win situation for both employers and employees.
Group health insurance can be far more reasonably priced than many
employers believe.
The Consumer-directed Group Insurance Plan is preferred by many
different sized companies. This health insurance plan provides low monthly fees
for both the employers and the employees.
The Health Savings Account Plans and the Cafeteria Plans are two of the
most popular consumer-directed plans being availed by businesses.
The Comprehensive Group Health Insurance, on the other hand, gives
consumers the options to manage a health insurance group. This plan creates a
network of specialists, doctors, medical professionals, and hospitals for an affordable
and discounted medical plan. The employers and employees will benefit from this
plan because of its low premium fees, coinsurance and copayments.
The Preferred Provider Organization (PRO), Health Maintenance
Organization (HMO) and Point of Service (POS) are the most affordable
comprehensive group health plans that are availed by employers for their
workers.
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01/30/2010
Companies interested
in purchasing group health insurance are advised to carefully weigh their
options to ensure that health plans are tailored according to the needs of the
employees.
In searching for the
right group health insurance, it is important to understand the needs and
preferences of an employee with regards to healthcare plans. Research is
necessary in order to know about the different policy types and coverage
needed.
It is also important
to verify with the department of insurance if a company engaged in
business/group health insurance is licensed. Companies must stay away from small, unlicensed business
insurance companies even if they offer a good deal.
Another way to
determine a good group health insurance program is to check the company ratings.
Standard & Poor’s, Moody’s, and A.M. Best Company are examples of firms
that review and rate insurance companies based on credit obligations and
financial credit. Some of these firms even offer information on companies that
offer health plans for employees.
Referrals from other
companies that utilize the services of a group/business health insurance
company would greatly help in choosing the right program for employees. This
could provide insight on the service quality as well as the contact information
of a specific insurance company.
To examine the website
of a group health insurance company is also a must. Details such as products
and services, investor information, claims, customer services, and press
releases, could help in determining how the health insurance company works.
Oftentimes, the chosen
“best deal” is not exactly a good deal when reviewed properly. Thus, it is
important to keep in mind that a good group health insurance plan is
cost-effective and of high quality.
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01/30/2010
In the United States, there are many types of health insurances that
cater to different needs and preferences. One of the most common health
insurance is the PPO or Preferred Provider Organization.
PPO, also referred to as preferred provider option, is a group of
health care providers who work with an insurance company or a third-party
administration to provide inexpensive health care to a policy-holder. In a
Preferred Provider Organization (PPO), an individual subscribes to a specific policy
that allows them to receive discounted charges from “preferred” health care
providers of PPO.
Preferred Provider Organization (PPO) features a utilization review
wherein the policy-holder or the third-party administration reviews the medical
records of the treatments provided to check if it was given as a treatment for
a specific condition, or just being used to get higher reimbursement. In addition, PPO also has
pre-certification requirement. This requires non-emergency admissions and some
outpatient surgeries to be pre-approved by the policy-holder, and have
undergone “utilization review” beforehand.
PPOs earn profit by implementing an access charge to a particular
insurance company for using their network. The organization negotiates with
health care providers in terms of establishing fee schedules. In addition, they
also supervise disputes between the providers and the policy-holders.
Moreover, PPOs also create an agreement with each other to establish a
stronger position within a particular area. Theorically speaking, this set-up
is advantageous for both the insurer and the providers. The policy-holders
remain to receive discounted medical expenses when they contract the services
of a “preferred provider”. In turn, there will be a significant increase in the
provider’s business since all insurers take advantage of the “preferred”
provider’s services.
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08/05/2009
Below the Employee Rate
Breakdown in a group or business health insurance proposal, there may be column
headings that indicate EE Rate, Total Rate, Dep Rate, ER Cont and EE Cont.
Though business health insurance quotes come in various formats, most insurance
providers use the same abbreviations. The EE Rate is the employee rate. This is
usually placed in the column to the far left, on that same line. This is the
rate of the employee’s insurance, regardless of whether they have dependents or
not. The Dep Rate column displays the rate for the employee’s requested
dependents, such as children. This rate is the total premium for all of the
dependents. The premium will not adjust if it is rated as “family”, or even if
the member or employee chooses to add more dependents to his or her health
plan. An employee’s total premium is displayed in the Total Rate column, which
includes the premium for the employee only, and the premium for their
dependents. In case that an employee does not enroll any dependents, the result
of the EE Rate will be the same as the Total Rate, and the space intended for
the Dep Rate will indicate $0.
The column labeled EE
contribution displays the percentage of the Total Rate which the employee will
shoulder. This is derived from the employee and dependent contribution portions
or percentages that are applied to compute the health plan quotes. In addition,
the column labeled ER contribution shows the percentage of the Total Rate which
the employer will shoulder. This amount should be equal to the difference
between the Total Rate and the EE Contribution. Each of the columns should show
a total amount at the bottom – this shows the combined rates for every
employee.
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08/05/2009
Typical insurance premiums
cost around 8% to 10% of the total payroll amount. The majority of this
percentage will go to health insurance coverage. Companies can offer three
kinds of health care coverage for their employees: either fee-for-service or
the traditional type of coverage, Health Maintenance Organization or HMO, and
Preferred Provider Organization or PPO.
The traditional health
plan or fee-for-service provides employees with the most flexible coverage. As
far as this type of coverage is concerned, there are no restrictions when it
comes to choice of doctors and hospitals. Because of their flexibility,
traditional health plans are usually more expensive.
Health Maintenance
Organization is the second type of health plan. Basically, HMOs are considered
prepaid health plans. Employees covered by an HMO can only seek services from
doctors and health providers inside the HMO network.
Employees under HMOs also
make co-payments worth $5 to $25 every time they go to the doctor’s office or
emergency room. Typically, employees also need to select their primary care
physicians (PCP) for health monitoring. PCPs also make the necessary referrals
if ever their patients need the services of specialists. HMOs are geared towards
preventive care.
As for the last main type
of health insurance coverage, Preferred Provider Organization works as a
combination of the traditional and HMO coverage. PPOs also have their own
network of doctors and hospitals, just like HMOs. Employees are also required
to have primary care physicians and pay small co-payments. However, employees
under PPOs are given the option to seek out-of-network services. This option
will require employees to pay more than the usual premium amount and to fill
out forms.
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08/05/2009
The total premium of a
health insurance policy should be clearly shown on the proposal’s summary page.
With all of the various financial figures that one usually finds in group
health insurance proposals, locating the important numbers can sometimes be
confusing.
Group or business health
insurance proposals are formatted in various ways, but they have some common
points that one can look for. Upon inspection, the group proposal should have a
“Plan Summary” or “Plan Grid” included in it. This part of the proposal should
provide a summary of the available group or business health plans from the
different insurance providers represented in the quote. One segment in this
summary will display the main details of the plan like co-payments,
deductibles, out-of-pocket limits, coinsurance percentages, coverage for
prescription drugs and hospitalization benefits. With the health plan choices
listed in the summary table, there is usually also a total cash amount
connected to each of the health plans. Usually, this amount will correspond to
the total premium for all the individuals and their dependents included in the
quote. This amount may or may not represent the premium cost that the employer
will pay per month. It will also depend on how much of the total premium the
employer intends to shoulder, as percentage of the employee and dependent
premium.
For instance, it is given
that the employer intends to shoulder 75% of the premium for all the members or
employees and dependents. For Health Plan X, which displays a total premium
worth $2,000 on the quote summary, the employer will pay $1,500. The remaining
$500, or 25% of the total, will then be charged to the employees.
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08/05/2009
Some companies or
organizations may want to be selective when it comes to deciding which of their
employees should receive health insurance, or they may want to offer different
levels of health insurance through different insurance providers, depending on
employee level or class. For instance, a company may wish to make health
insurance benefits available to their employees at the managerial level.
Placing limits on the number of employees or members that are able to obtain
group health insurance is called “group carve out”. Some common examples of
group carve outs are “management only”, “salary vs. non-salary” and “union vs.
non-union”.
It is the insurance
provider’s right to decide whether it allows carve outs or not. The provider
may also put certain limitations on which kinds of group carve outs it accepts.
The insurance carrier may also require that a carve-out group meets the
standard requirements for minimum participation. In addition they may even
request full, or 100%, participation of all the qualified members or employees
in that carve out group. Some insurance companies may also set a minimum number
of members per carve-out group.
Most of the time carve-out
groups are not included in the state health insurance law that mandates
guaranteed issue for small business or group health plans. Therefore an
insurance company may require each member or employee in a carve-out group to
answer health questionnaires. If a member of that group is categorized as
high-risk, the insurance company may decline their application for insurance
coverage. The options and choices available to group carve outs are often
limited. Additionally, insurance providers may also restrict the carve-out
group’s employer from offering alternative choices or options through other
insurance companies.
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08/05/2009
Usually an employee must
work for a company for a specified amount of time before he or she becomes
eligible for that company’s group health insurance plan. In the terms of the
health insurance policy, this is called a “waiting period”. If an employer is
going to establish a new group health insurance plan, he or she must select a
preferred waiting period for newly hired employees from several choices or
options. The options available for waiting periods may differ from one
insurance carrier to another, and it can range from one month to one year
following the date of employment.
The waiting period does
not affect or apply to employees who are employed by a company at the time the
group health plan is initially established. However, a company may impose the
waiting period on recently hired employees who do not meet the group health
policy’s selected waiting period.
Most of the time, group
health insurance plans have a “first of the month” effective date for the inclusion
of any new qualified employee. This means that if a company has a waiting
period of one month, a recently hired employee may enroll in the group health
plan on the first day of the month following the date he or she began working
for the company. For instance, if a newly hired employee starts working on
November 18 for a company that has a waiting period of one month, he or she
will then be qualified to enroll in the group health plan on January 1. A
company’s selected waiting period at the time of the group health plan’s
establishment must be applied to all new employees.
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08/05/2009
Group insurance is one of
the most important benefits a company can offer its employees. In these
difficult days, some workers even choose to stay with a company just to keep
their health insurance coverage. Even businesses with as few as five employees
can offer health care coverage through group health insurance.
Group health insurance is
employer-sponsored health-care coverage issued to a group, such as trade
associations and credit unions, which provides health coverage for group
members and their dependents. With group health insurance, business owners
usually pay at least half of their workers’ health-care monthly premiums.
How does group health
insurance work? When the employee and his/her eligible dependents satisfy the
"deductible," which is the first part of the total eligible costs
that occur within a given year of coverage, the insurance company usually
shoulders 80% of the eligible expenses. Moreover, group health insurance
provides the insured with health coverage regardless of any pre-existing
medical condition.
Group health insurance
usually covers physician fees, nursing services, X-rays and medicines.
Exclusions from the provision of medical benefits under group health insurance
include certain mouth conditions, rest cures, expenses incurred due to
self-inflicted injuries and the medical expenses of a member of another Health
Maintenance Organization (HMO).
If the insured has two insurance plans, one health
plan becomes the primary health insurance which shoulders the insured’s health
care costs until the maximum eligible expense level is reached. Usually a
health plan covers health care costs of up to $5,000. The other plan, which is
the secondary insurance, pays for the expenses not covered by the primary plan
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08/05/2009
According to a report,
more than 60% of Americans with health insurance get their coverage through a
group health insurance plan sponsored by their employer. These employers make
use of health insurance plans that are specifically designed for small or large
businesses. It is a fact that for many employees, health insurance is the most
valuable benefit that their job offers them. A large percent of the revenues
that health insurance companies earn is made up of the billions of dollars
spent by U.S. companies on their employees’ health insurance.
Recently, for companies in
the U.S., the cost of providing health care insurance for employees has seen a
remarkable increase. This increase is principally due to the increasing costs
of prescription drugs and health care. Many U.S. companies have been forced to
reduce the benefits enjoyed by their employees under their group health
insurance plans because of these continually increasing insurance costs. As a
result when employees need prescription drugs or medical treatment, the
expenses that come out of their own pockets increase as well.
Due to the health
insurance offered by U.S. employers, a large number of Americans are compelled
to stay with their company. This is even more common amongst those employees
who depend on the benefits provided by their employer because they have a
pre-existing medical condition that prevents them from acquiring an individual
health insurance plan. It even comes to a point when such employees are willing
to continue working for a company despite a lower salary, just to enjoy these
benefits.
U.S. companies that offer
these kinds of health care benefits usually have a low rate of staff turnover.
Attracting quality employees and lowering the rate of employee turnover are actually
the two main reasons given by employers for offering such benefits in the first
place.
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08/05/2009
Business or
group health coverage is defined as any type of employer-sponsored medical
insurance for business owners, employees and their dependents. The majority of Americans with health
insurance have this type of medical coverage.
General
requirements in most states identify at least two workers as a business and
therefore eligible for group medical coverage. However, some states set a lower threshold and a few even
allow “business groups of one” which make it possible for sole proprietors to
buy health insurance at group rates.
If you own your own business, check with your state’s insurance
department to determine the particular regulations in your area.
With group
health coverage, employers and employees split monthly premiums based on
percentages. Though there is
variation across plans, in most groups employers cover the bigger portion of
the premium, typically at least 50 percent. There are different laws, benefits, coverage options and
costs associated with small and large businesses. Small businesses are generally defined as companies with
less than 50 employees; large businesses have more than 50 employees.
Whether a
business is classified as small or large, group coverage has the same basic
structure. The employer chooses
the plan that best fits the company’s needs and workers can either accept
enrollment or seek other alternatives for health insurance. Most group health plans are
underwritten by a health insurance company, though some very large businesses
can choose to self-insure health care coverage for employees. This means that instead of paying
premiums to an insurance company, the business sets aside funds to cover the
cost of employee health care and therefore assumes all risks associated with benefits
and claims. A self-insured plan
could drastically influence the quality of care you receive if you develop a
serious medical condition or are significantly injured so it is wise to find
out how your employer’s group policy is funded. Regardless of the type of underwriting your employer
chooses, however, all group health insurance is subject to state regulation.
With small
group coverage, no employee can be turned down for insurance regardless of
their medical history. Plans must
be renewed by the underwriting company each year provided the business complies
with all the terms of the policy agreement; premiums are paid on time, there
has been no fraudulent claims activity and no breach of contract. This kind of coverage protects
employees of small firms who might not otherwise have access to health
insurance plans.
For large
businesses, the rules are slightly more restrictive. Large group plans can deny coverage based on employees’
medical histories and can exclude certain pre-existing conditions from the
coverage offered. In fact, whole
companies can be rejected based on past-claims history, though once a policy is
issued to the business every employee of that business must be included in the
coverage. Policies have to be
renewed by the underwriter every year as long as the business complies with all
the terms of the contract.
Companies
that provide group health insurance for their workers are able to attract new
employees, retain quality personnel and reap tax benefits. No matter what the size of your company
is, offering a group plan makes sense.
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08/05/2009
Although not required, health
plans for workers in small businesses are often provided by their employer. In
good business practices, providing a health plan is usually used as an
incentive to hire the best people.
A business with two to 50
employees is considered a small business. Many small business employers offer
health plans through group health insurance plans that use organized medical
networks such as Health Maintenance Organizations (HMO), Preferred Provider Organizations
(PPO), Point of Service (POS) and the new Health Savings Accounts. Each of these options has different
characteristics that may affect your new health insurance choice.
Many employers get HMO plans
because they have low premiums. PPO and POS plans usually cost slightly more
but are more flexible, allowing workers to use their own doctor and medical
care choices. The HAS plans, the newest option in the market, provides
employers and workers with a way to save money through tax-free expenses.
A certain group of small
industries can also join together to form a bigger group which acts as a
“purchasing group” for health insurance. There are many Alliances or pools of
small businesses types, some are even statewide. To form a pool of small businesses,
check with your state insurance commissioner or your Chamber of Commerce.
Although this is a great idea in many states, in some cases this may also not
work best for you, depending on where you live.
How to lower the cost of my
health insurance plan?
Lowering the cost of these health
plans is always a concern for employers. Changing the deductible affects the
premium employers have to pay every month. Additional coverage also affects the
cost of the plan. Some small businesses include additional options, such as
vision, dental and alternative medicines, which add more costs. Increasing the
options and health benefits, increases the premiums. Moreover, health insurance
plans provide two maximum limits that affect the premium price: the maximum
limit over a person’s lifetime and the maximum limit for each claim. The higher
limits also mean higher premiums.
When looking for more efficient
but affordable health insurance for small businesses, there are certain points
a business owner should consider. It always helps if you understand the types
of medical networks used in group or business health plans, and the amount of
the deductible you choose when setting up the health policy, as this also
greatly affects how much you will pay for the premium. It also helps a lot to
compare your final two options’ annual premiums and the approximate amount your
workers will have to pay out-of-pocket, yearly. Check whether both you and your
workers can afford the cost of the health plan. Considering the total costs of
the policies, including the estimated out-of-pocket expenses of your employees,
and the services offered by the policies will probably help you make a good
decision on which type of group health insurance you will choose. If you think you will be spending too much,
having your small business become a member of small business alliance in your
state may also help to access affordable health insurance policies.
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08/05/2009
When you
enroll in a group health insurance plan you join a group of other people and
combine your purchasing power in order to obtain healthcare. Since the insurer covers the whole
group rather than individuals, everyone shares the costs. Payments are combined and used to help
offset the cost of care for all members—healthy people essentially pay for
treatment for sick people with the understanding that this same help will be
available to them if or when they need it because they, too, are members of the
group. This system reduces the
risk of personal financial disaster due to healthcare costs that may arise from
injury, illness, or medical condition.
The
following is an example of how a typical group health insurance plan works:
Joe has a medical
health insurance plan through his job with a $1,000 yearly deductible, 15%
patient responsibility after the deductible has been met, a $4,000 out-of-pocket
limit per year, and a $5 million lifetime maximum. At his annual physical, Joe’s doctor tells him he’ll have to
have an operation that is going to cost $100,000. Joe doesn’t panic, though, because the operation is an
approved treatment and will be covered by his medical insurance. With his deductible—the amount Joe must
pay out of pocket before his insurance policy coverage kicks in—Joe must pay
the first $1,000 of the cost of his surgery. After that, Joe’s insurance will kick in with a percentage
of the total cost called coinsurance.
Because his policy has a 15% patient responsibility, after Joe pays his
deductible his insurance company will pay 85% of the remaining cost of the
surgery, or $84,150. Joe must pay
15%, but only until his annual out-of-pocket maximum is reached. The out-of-pocket cap is the maximum
amount a patient will have to pay for healthcare each year. Joe’s out-of-pocket maximum is $4,000,
so Joe will be responsible for his $1,000 deductible as well as an additional
$3,000 to reach his out of pocket cap.
Joe’s insurance company will assume responsibility for the remaining
$11,850. This brings the insurer’s
total contribution to the cost of Joe’s surgery to $96,000. Even if Joe has to go to the hospital
again before the calendar year is up, because his annual maximum and deductible
have been met, his insurance will pay 100 percent of his expenses. Joe’s lifetime maximum is $5 million,
so his insurance will continue to pay his medical bills up to that amount for
the life of his policy, provided Joe pays his premiums on time, and meets his
yearly deductibles, his percentage of coinsurance, and his out-of-pocket
maximums as needed. Joe’s surgery
is a success and he goes to see his doctor for a follow-up appointment. The surgeon’s office charges $250 for a
visit and Joe’s insurance plan requires a co-payment for doctor visits. If Joe’s plan has a $20 co-pay then Joe
is responsible for that amount and his insurance company will cover the
remaining $230 for the cost of the appointment.
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08/05/2009
A Health Savings
Account (HSA) is a way for people to save money that they can use to pay for
medical expenses. The funds
contributed to these accounts are designated to pay for routine medical care or
can be left to build interest. The
money can either be withdrawn during the year to pay for healthcare, or can be
left alone and used as a savings account for the future. The program was signed into law in
December 2003; and first became available in January 2004.
All HSAs
have two major qualifications:
participants must already be enrolled in a high deductible insurance
plan, and the account is subject to the same regulations as a tax-free trust
made up of a combination of savings and investments.
An HSA only
covers qualifying medical expenses as determined by the IRS. This prevents fraud and helps secure
funds for when people need them most.
The coverage options for an HSA are quite broad and include things like
dental and vision care that many traditional insurance plans do not offer.
The
premiums for an HSA are generally much lower than those of some comprehensive
plans that also require co-pays, as well.
Since the funding for an HSA is theoretically generated from the fact
that money is not being spent on an insurance plan, participants are spared
co-pays and yearly deductibles. Individuals
can also deduct the annual deposits to their HSA from their gross yearly
income, resulting in tax-free savings.
This all generates a comparatively lower out-of-pocket cost for participation
in an HSA than a more traditional healthcare plan.
The policy
of allowing money to stay in the HSA even if it is not being used also
encourages consumers to become educated about their health insurance, and makes
policy purchasers more of a driving force in the process of buying and selling
health insurance. Owners of HSAs
have more incentive to check medical bills carefully, compare the costs of
treatments, and to honestly evaluate their medical needs in order to protect
their savings.
Not
everyone is able to start an HSA; eligibility standards do apply. Patients must first have a high
deductible health plan (HDHP), which means that the annual plan deductible for
an individual must be at least $1,050 with out-of-pocket expenses not exceeding
$5,250 per year. For families, a
policy qualifies as an HDHP if the annual premium is at least $2,100 and
out-of-pocket expenses are no more than $10,500. These HDHPs may not charge co-pays for doctor visits or
prescriptions, but they can be network plans like HMOs or PPOs. An HDHP may have a low deductible
benefit so long as that benefit only applies to preventative care. HDHP family plans only qualify for an
HSA if insurance will not cover any services until the entire plan deductible
is met.
If you set
up an HSA but do not have a qualifying high deductible health plan you can be
penalized by the federal government.
If you think you might qualify for a health savings account or want more
information, consult an insurance professional before taking action.
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08/05/2009
According to
the United States Census Bureau, almost 25% of Charlottesville’s population does
not have health insurance.
There are a few
renowned hospitals in Charlottesville, including Martha Jefferson and the
University of Virginia Medical Center. Still, one in four people living in
Charlottesville does not have individual health insurance. According to
exports, college towns usually have more people who are uninsured.
When Brittany
Burgess, a resident of Charlottesville, turned 19, she decided to stop getting
individual health insurance. She chose not to have insurance because she says
she is healthy.
“I've never
tried looking into getting everything. I'll just deal without it until I really
need it,” she said.
Charlottesville’s
free clinic tends to hundreds of patients every day who do not have insurance.
According to Charlottesville Free Clinic Executive Director Erika Viccellio,
more than 30% of the youth are uninsured.
“A lot of
that has to do with trying to find jobs, or they might have beginning jobs that
don't offer health insurance,” she said. “They're typically healthy, and they
decide not to pay for expensive health insurance.”
Another
reason for the high number of uninsured, according to Viccellio, is that many
students do not leave Charlottesville immediately after they finish school.
However, that is not the sole reason.
“Charlottesville
has more small employers than large employers, and it's hard for small
employers to offer health insurance. It's expensive,” she said.
Students of
the University of Virginia are usually well-insured. In order to enroll,
students are required to have health insurance for their first school year; however,
they can drop their coverage after that. According to Dr. James Turner of the
university’s Student Health, the university’s students are the largest group of
insured people in Charlottesville.
Click here to view this article
08/05/2009
Many people feel that group health insurance is better than individual
health insurance because the former usually costs less and provides more
benefits than the latter.
However, many people cannot get group health plans because they work for
a small company that does not provide them with group health insurance, they
are self-employed, or they have run out of COBRA benefits. Thus, their only
option is to purchase individual health insurance.
Individual health plans are offered by many insurance companies;
however, people who are over 50 years old, especially those with medical
problems, are often declined by insurance companies.
Before enrolling in an individual health plan, it is important to
consider how much of your physician and hospital bills the insurance will
cover, how much you will have to pay in premiums, and how much you have to pay
before the plan starts to pay for your medical expenses.
Enrolling in an individual health plan provides you with several
options, such as fee-for-service policies and managed care plans.
Also called indemnity insurance, a fee-for-service insurance plan is a
traditional type of health insurance that pays a portion of every medical
service you access, such as hospital stays and physician visits. With this type
of plan, although you pay for the rest of the expenses, you can go to the
hospital and doctor of your choice.
A managed health plan, on the other hand, is insurance provided by a
group such as a Preferred Provider Organization (PPO) or Health Maintenance
Organization (HMO). Insurers that offer managed health plans contract with
hospitals and physicians, which make up the "network" of the plan.
With this type of individual insurance, the insured are advised to patronize
the physicians and hospitals that are part of their plan's network.
Other types of individual health insurance are Open Enrollment in
Managed Care Plans and Association-Based Health Insurance.
Click here to view this article
08/05/2009
Often, people with small
businesses do not have health insurance plans. It is important for them to find
health coverage through a self-employed health insurance plan. What they need
is an affordable, quick and easy health plan.
Being hurt or struck by a
sickness is tragic not only to one’s family but also to one’s finances.
Although sicknesses and accidents may come anytime— sometimes, when they are
least expected—one can be prepared for them by having a health plan. As an
owner of a small business, a person can get health coverage through a variety
of plans. He or she may consider looking into plans that are like discount
cards, a family plan that can cover him or her as a business owner, or group
health insurance plans for the self-employed. Also, individual health care
plans may be an option.
It is not difficult to
look into different health insurance policies available; one can secure online
quotes in no time. Eye care, dental and ER services may be obtained along with
quotes for health coverage. Knowing the type of insurance to look for is
important. Some plans offer discount cards that can be used in transactions
with anyone who accepts them. These types of plans are ‘down-to-earth’.
However, there are other, more typical insurance plans, which may require one
to wait in order to be covered for any pre-existing condition.
There are many different
types of health insurance policies for the self-employed. Quotes for these can
be easily organized online.
Click here to view this article
08/05/2009
As the U.S. government
continues to work on reforming the country’s health care system, business
groups fear that many small companies throughout Southeast Valley would be
forced to shut down.
The senate proposal for
the bill on health care reform would compel employers to provide business
health insurance for their workers. Otherwise, they need to contribute a fee
worth 8% of their payrolls for a government-managed insurance plan.
Via Homes president, Trudy
Licano, said that "A lot of times legislation is meant to help people, but
this could shut doors. There's going to be a pretty huge impact on us. Some
businesses just can't afford it."
Under the said bill,
employers who will provide insurance for their workers would be required to
cover 72.5% of the premium cost for full-time employees and 65% for family
policies. Companies are also required to insure their part-time workers.
However, some businesses would be exempted depending on their size, which has
yet to be determined.
Mary Ann Miller, president
and CEO of Tempe Chamber of Commerce, explained the possible effect of the
proposed health bill to the business sector: "I think that most businesses
would love to be able to provide health insurance to its employees, and do so
wherever they can. But mandating such coverage will only drive up costs for
businesses of all sizes during tough economic times."
Last month’s proposed bill
was described by the U.S. Chamber of Commerce as "a dangerous proposal."
According to Jack Alspaugh
of the Arizona Small Business Association, companies with less than 50
employees will find it difficult to balance efforts between providing coverage
to their employees and maintaining their payrolls.
The Senate and House
members are still working out the details of the bill, which President Obama
wants to sign by fall.
Click here to view this article
08/05/2009
Brian Urban, an insurance
broker, refused to believe a caller who told him a story about an owner of a
small business in Nebraska who couldn’t afford health plan premiums because it
would require him to pay around $24,000 to $40,000 annually.
Urban said, “Just the size
of the numbers was far out of what the market would dictate even for someone
with some severe medical conditions. And according to the story, these were
healthy individuals.”
The Nebraska health insurance
market is a familiar territory for Urban since he is the CEO of Corporate
Resource Group, as well as the legislative chairman in Nebraska for the
National Association of Health Underwriters.
33-year-old Larry Harbour
was the man who complained about the high cost of premiums. As the owner of LB
Custom Chrome and Detail in Nebraska, he tried his best to find affordable
insurance coverage. In a phone call, Urban offered to get Harbour affordable
premiums.
Harbour, who was happy to
hear Urban’s offer, described the search for health insurance as “very
confusing.” “It's very tough to understand unless you have someone, so to
speak, holding your hand and walking you through the process.”
Urban’s phone call was the
first of many geared toward helping Harbour find affordable business health
insurance coverage. “According to the story, he was uninsured, and I don't find
that acceptable. It's my job to make sure that as many people are insured as
possible,” Urban said.
Urban also made a comment
about how confusing premiums affect the health insurance debate. “We're not
opposed to reform. It's just that we want to make sure we're dealing with
real-life facts and numbers and that reform is focused on the areas it's truly
needed.”
Click here to view this article
08/05/2009
After Wal-Mart pledged support for the proposal that
requires employers to contribute to their workers’ health insurance costs, the
National Retail Federation is asking its members to oppose Wal-Mart’s stance on
the issue.
In a letter issued by NRF chief executive Tracy
Mullin, group members are urged to “Come out swinging.” He added that, “To
truly lead on the health care debate, it is imperative that businesses,
associations and politicians take a stand where it counts and not shy away from
deal-breakers like employer mandates.”
The letter shows the different views of companies
toward the health care reform, which aims to cover the uninsured.
Different companies have allowed trade groups like the
National Retail Federation, the largest trade group in the industry, and the
Chamber of Commerce, the biggest business lobbying organization in the country,
to spearhead the opposition to the health care plans in congress. Wal-Mart
isn’t part of the NRF.
In a June letter to the senators in the drafting
committees, the NRF said that it would prompt its members to oppose politicians
who support an employer mandate. Meanwhile, the Service Employees International
Union, Wal-Mart, and the Center for American Progress sent their own letter to
the White House, voicing their support for a company mandate that will urge
employers to provide health benefits like group health insurance to their
employees.
The letter was signed by Michael Duke, president and
CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president
of the Center for American Progress.
The NRF is not alone in expressing opposition to
Wal-Mart’s stance. In its letter to the White House, the United Food and
Commercial Workers Union raised questions about Wal-Mart’s position.
Click here to view this article
08/05/2009
Large group health
insurance is also called corporate group health insurance. A company will be
categorized under and qualified for this type of insurance if its number of
employees grows beyond the limit of companies classified as “mid-size.” Each of
the insurance companies has eligibility requirements on how many employees a
company must have in order for it to qualify for large group health insurance.
This is the highest category for group health insurance, so usually there is no
limit to the number of members or employees accepted.
In addition to better
flexibility, corporate group health insurance has many similarities to mid-size
group health insurance policies. In most health insurance providers’ portfolios,
one would usually see a greater selection of plan options under the large group
category. Large group health insurance policies are not the guaranteed issue
type, as is the case with mid-size group health insurance. However, large
companies or groups usually do not have many “high risk” employees or members.
Thus, it is less likely that the group concerned would be denied insurance
coverage for this reason.
Additional benefits are
offered to large groups that are not available to smaller group sizes. This is
because the insurance providers or companies assume the cost of these benefits,
with the risks covered and absorbed by the total premium usually charged to
large groups.
When searching for a large
group health insurance policy, the concerned party must study the available
options offered by the insurance companies in their state. There may be
significant differences regarding the premiums charged and the benefits
provided. Additionally, it is also important to know employees’ needs and wants
pertaining to health insurance. If the group’s size is large enough, the
insurance company might provide them with additional benefits.
Click here to view this article
08/05/2009
Some insurance providers
call Mid-size Group Health Insurance “mid-market” health insurance. Compared to
small group health insurance, Mid-Size Group Health Insurance presents more
plan choices. Depending on the insurance company, the number of required
members or employees needed to qualify for this category may vary. Usually, if
a certain company goes over the 50-member maximum count for small group health
insurance, it will be offered with the next level benefits, and this will fall
into the mid-sized category. More plans are offered under this category, and
some of these plans have better benefits than the ones presented to smaller
groups.
Not being a guaranteed
issue is one distinguishing feature of Mid-Size Group Health Insurance.
Therefore, a mid-sized company that has many employees with health problems may
be refused insurance. Consequently, an insurance provider may request a claims
history report from the concerned company’s previous health insurance provider.
They may also issue a health survey that will query how many employees have
particular medical conditions, such as diabetes, pregnancy, cancer, or other
health conditions with great claim payouts. The group or company will be
evaluated as one entity, and not per employee.
In searching for insurance
providers that offer Mid-Size Group Health Insurance, the interested party has
to consider several of the available options. Additionally, the concerned party
should ask for both composite and age-rate quotes. A composite-rated Mid-Size
Group Health Insurance provides a flat rate, which will be paid by each of the
employees. This way, if the company lets its employees pay for a share of the
insurance costs, bookkeeping would be simplified. An insurance that is
age-rated has premiums rated in relation to the age of the employee. This is
rated per employee.
Click here to view this article
08/05/2009
Every state has its own
regulations that determine how small a business should be in order to fall
under the classification of a “small business.” Businesses that fall under the
small-business category are qualified for small group health insurance. In
order to be classified as a small business, a company usually has to have from
2 to 50 members or employees. In some situations, insurance companies may
promote small group health insurance policies to a solo and self-employed
individual. These one-person groups are not eligible for particular guarantees
or policies that pertain to groups with more members.
Health insurance is
state-regulated; thus, the laws that regulate small group health insurance may
vary considerable. However, there are still some common procedures being
followed in most U.S. states. Further information about state-specific laws can
be gathered from a state’s State Department of Insurance or a duly accredited
small business health insurance broker.
One of the main advantages
of being categorized as a “small group” is that the company’s coverage of
health insurance is assured by the health insurance provider. Therefore, if a
company qualifies and meets the requirements of being classified as a “small
group,” the insurance provider must grant and approve the application,
regardless of past and present health conditions of all the company’s
employees. This is called guaranteed issue coverage. The insurance provider may
still ask the employees some health questions, but this is only performed to
rate the premium for the group health plan.
There are particular
eligibility requirements in order to qualify for a small group health insurance
plan. The company needs to prove that it is a legitimate and legal entity. The
tax payer identification number, business tax returns, payroll records,
business license, and other documents are needed for this.
Click here to view this article
08/05/2009
Finding a good broker is
important when choosing the right health insurance coverage for your employees.
A broker can present a number of health plans from different insurance
providers. A vast number of options will enable you to make a comprehensive
comparison of health insurance offers.
Rates of deductibles and
co-insurance are valuable factors to consider when choosing a health insurance
plan. A policy that requires a co-payment of more than 25% of the total cost of
procedures is not a good insurance plan. A good health insurance plan should
offer a range of services, as well as coverage for pre-existing medical
conditions and long-term illnesses. Coverage should be at least $1 million.
And, to further evaluate maximum reimbursement for health care procedures,
check with local doctors to learn their rates.
The next thing to check is
the insurers themselves. Standard and Poor’s website contains a lot of helpful
information about the financial health of different insurance companies. An
insurer’s claim payment history is also important to know. Nobody wants an
insurer with a bad record when it comes to paying claims. Normally, a broker
can help you out in this area.
If your business is a
small one, your state’s department of insurance can help you to find health
providers that provide coverage specifically for small businesses in your area.
Another option would be consulting association plans or health purchasing
alliances. Health purchasing alliances enable small business owners to avail
themselves of group health insurance coverage at a lower price.
Whether you own a small or
large business, the only way to get the best insurance deal is to do your
homework.
Click here to view this article
07/28/2009
After Wal-Mart pledged support for the proposal that requires employers to contribute to their workers’ health insurance costs, the National Retail Federation is asking its members to oppose Wal-Mart’s stance on the issue.
In a letter issued by NRF chief executive Tracy Mullin, group members are urged to “Come out swinging.” He added that, “To truly lead on the health care debate, it is imperative that businesses, associations and politicians take a stand where it counts and not shy away from deal-breakers like employer mandates.”
The letter shows the different views of companies toward the health care reform, which aims to cover the uninsured.
Different companies have allowed trade groups like the National Retail Federation, the largest trade group in the industry, and the Chamber of Commerce, the biggest business lobbying organization in the country, to spearhead the opposition to the health care plans in congress. Wal-Mart isn’t part of the NRF.
In a June letter to the senators in the drafting committees, the NRF said that it would prompt its members to oppose politicians who support an employer mandate. Meanwhile, the Service Employees International Union, Wal-Mart, and the Center for American Progress sent their own letter to the White House, voicing their support for a company mandate that will urge employers to provide health benefits like group health insurance to their employees.
The letter was signed by Michael Duke, president and CEO of Wal-Mart, Andrew Stern, president of SEIU, and John Podesta, president of the Center for American Progress.
The NRF is not alone in expressing opposition to Wal-Mart’s stance. In its letter to the White House, the United Food and Commercial Workers Union raised questions about Wal-Mart’s position.
Click here to view this article
07/13/2009
Brian Urban, an insurance broker, refused to believe a caller who told him a story about an owner of a small business in Nebraska who couldn’t afford health plan premiums because it would require him to pay around $24,000 to $40,000 annually.
Urban said, “Just the size of the numbers was far out of what the market would dictate even for someone with some severe medical conditions. And according to the story, these were healthy individuals.”
The Nebraska health insurance market is a familiar territory for Urban since he is the CEO of Corporate Resource Group, as well as the legislative chairman in Nebraska for the National Association of Health Underwriters.
33-year-old Larry Harbour was the man who complained about the high cost of premiums. As the owner of LB Custom Chrome and Detail in Nebraska, he tried his best to find affordable insurance coverage. In a phone call, Urban offered to get Harbour affordable premiums.
Harbour, who was happy to hear Urban’s offer, described the search for health insurance as “very confusing.” “It's very tough to understand unless you have someone, so to speak, holding your hand and walking you through the process.”
Urban’s phone call was the first of many geared toward helping Harbour find affordable business health insurance coverage. “According to the story, he was uninsured, and I don't find that acceptable. It's my job to make sure that as many people are insured as possible,” Urban said.
Urban also made a comment about how confusing premiums affect the health insurance debate. “We're not opposed to reform. It's just that we want to make sure we're dealing with real-life facts and numbers and that reform is focused on the areas it's truly needed.”
Click here to view this article
07/13/2009
As the U.S. government continues to work on reforming the country’s health care system, business groups fear that many small companies throughout Southeast Valley would be forced to shut down.
The senate proposal for the bill on health care reform would compel employers to provide business health insurance for their workers. Otherwise, they need to contribute a fee worth 8% of their payrolls for a government-managed insurance plan.
Via Homes president, Trudy Licano, said that "A lot of times legislation is meant to help people, but this could shut doors. There's going to be a pretty huge impact on us. Some businesses just can't afford it."
Under the said bill, employers who will provide insurance for their workers would be required to cover 72.5% of the premium cost for full-time employees and 65% for family policies. Companies are also required to insure their part-time workers. However, some businesses would be exempted depending on their size, which has yet to be determined.
Mary Ann Miller, president and CEO of Tempe Chamber of Commerce, explained the possible effect of the proposed health bill to the business sector: "I think that most businesses would love to be able to provide health insurance to its employees, and do so wherever they can. But mandating such coverage will only drive up costs for businesses of all sizes during tough economic times."
Last month’s proposed bill was described by the U.S. Chamber of Commerce as "a dangerous proposal."
According to Jack Alspaugh of the Arizona Small Business Association, companies with less than 50 employees will find it difficult to balance efforts between providing coverage to their employees and maintaining their payrolls.
The Senate and House members are still working out the details of the bill, which President Obama wants to sign by fall.
Click here to view this article
07/13/2009
Due to the soaring cost of health care, small businesses in Utah are now ready to embrace a health care reform, including the government-run insurance option, just to offer health care subsidy to their workers and earn a profit.
A recent survey reveals only 40% of the 300 randomly chosen businesses provide health care insurance to their employees, and 79% of those are struggling to subsidize their workers’ health plans. In addition, 88% of the companies that dropped their employees’ health coverage say they cannot afford to shoulder the costs anymore.
“What comes through loud and clear is the health crisis is huge, it’s crushing, and something needs to be done right away,” said John Arensmeyer, CEO and founder of Small Business Majority.
Small business owners in Utah believe a comprehensive reform on health care is an economic necessity, and that controlling the costs should be the top priority of the reform.
“The problem is that the cost of the health insurance is rising,” said Betsy Burton, a small bookshop owner, whose health plan cost increased by more than 20% last year. “At that rate, it is really difficult to make a profit in a business like this, with a low profit margin,” she said.
While almost 50% of business leaders in Utah consider themselves as Republicans and identify themselves as having conservative political views, small businesses in the state are now ready to embrace a bold health care system reform.
The struggle of small businesses with the rising cost of health care and their eagerness to do something to solve the problem is not really surprising, said Judi Hilman, executive director of the Utah Health Policy Project. "It is because small businesses are the first that experience the current problems in our system," she explained.
Click here to view this article
07/13/2009
For small-business owners, maintaining their workers’ health insurance is becoming increasingly difficult with the soaring costs and a weak economy.
Pedro Alfonso, owner of the small telecommunications firm Dynamic Concepts Inc. said subsidizing the health plans of his 85 employees now entails out-of-pocket costs. Alfonso says that before, his company could afford 70% of its workers’ insurance premiums. Now, however, it can only pay 35%.
Alfonso, 61, said that rising health costs is hard for workers. “But it’s also hard on us,” he added.
Small companies, such as Alfonso’s, are among those which the non-partisan Congressional Budget Office (CBO) is concerned about. With higher health costs, 15 million people employed in small companies may lose their health plan benefits or may voluntarily drop their health insurance. Moreover, about 10% of small-business employers are now contemplating dropping their workers’ health coverage next year due to the sky-high health care costs.
Based on an incomplete bill in the Senate Health, Education, Labor and Pensions Committee, employees working in small companies are more vulnerable, especially if their company is paying for high premiums.
Policy analyst at the Heritage Foundation, Greg D’Angelo, agrees that the current insurance system does not work for owners of small companies. “The number of people who will lose their health-plan benefits depends on what the lawmakers are still negotiating,” he added.
Based on CBO estimates, over 10 million people who receive low wages would choose to terminate their current, high-cost insurance plans. With the government’s proposed health care overhaul, workers at small firms will most likely buy cheaper insurance in the open market.
Click here to view this article
03/04/2007
HOUMA -- Drug testing is widespread in Terrebonne and Lafourche parishes, due in part to the high level of skilled industrial jobs available in the area.
Frank Bonvillian, general manager of MMSI Services, a drug-testing company at 409 N. Hollywood Road in Houma, said much of the company's business comes from area firms that send workers to jobs at big oil companies in the region.
It's not just a local rule; it's one required by the federal government. The U.S. Department of Transportation requires drug testing for employees in safety-sensitive jobs.
Click here to view this article
03/03/2007
With health-care premiums rising at a rate faster than the rate of inflation and wages, health-care costs have been among the top concerns for members of the Pennsylvania Chamber of Business and Industry for the past several years.
The PA Chamber supports the administration's efforts to increase access to health-care coverage, improve the quality of medical care and better control the cost of services.
Click here to view this article
03/01/2007
Message from the Chairman
Robert Wood Johnson IV is a member of the founding family of Johnson & Johnson, the worldwide healthcare corporation. He serves on the board of the Robert Wood Johnson Foundation and numerous business and philanthropic organizations. His family has been affected by both lupus and juvenile diabetes, which has motivated Mr. Johnson to take a leading role in raising funds to prevent, treat, and cure autoimmune diseases. Besides chairing the Alliance, he is chairman of the Juvenile Diabetes Research Foundation International (JDRF), and co-chairman of JDRF's Research Partnership.Closing in on a Cure. Mr.
Click here to view this article
03/01/2007
WASHINGTON, D.C. (March 1, 2007) - Speaking on behalf of
the National Association of Insurance Commissioners (NAIC), Michael
McRaith, Director of the Illinois Division of Insurance, testified
Wednesday before the Senate Committee on Banking, Housing, and Urban
Affairs on the need for a federal government/private market partnership to
insure terrorism risk. McRaith applauded the Committee for holding the
hearing early in the legislative session and urged Congress to move
quickly to avoid the market disruptions and uncertainty that followed the
September 11 terror attacks.
Click here to view this article
03/01/2007
Schwarzenegger Health Insurance Plan Would Drive Up Costs
Medicare Recipients Warned to Resist Aggressive Marketing
"How Do Households Choose Their Employer-Based Health Insurance?" by Jean- Marie Abraham, William B. Vogt, Martin S. Gaynor -- This study found that price influences workers' selection of employer-based health coverage, and that price sensitivity varies depending on marital status, wealth, and the number of employer coverage offers a household has.
Click here to view this article
03/01/2007
New York has had one of the worst workers' compensation systems in the country. For the past 15 years, New York's maximum weekly benefit stood at $400 - lower than every state except Mississippi and Arizona, not to mention the minimum benefit: $40 a week. Regionally, New York ranks last among nine states (from a high of $1,124 in New Hampshire down to New Jersey's benefit of $691). The value of that $400 benefit is less than $288 in 1992 dollars. Most of New York's injured workers receive a benefit that puts them below the federal poverty line for a family of four.
Click here to view this article
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