Tag Archives: health insurance

Open Enrollment 2018: Key Information, Dates and Reminders

Doctor visit

If you are currently without health insurance, Open Enrollment for individuals is here. Open Enrollment is your opportunity to purchase this coverage so that you can be covered on January 1, 2018.

It is important to be aware that if you are earning an income above the Federal Poverty Level, you will be required to pay a penalty for any three consecutive months that you are without health insurance. If you have lost your coverage previously sponsored by an employer, or you no longer qualify to be on your parent’s plan because you are over 26 years old, Open Enrollment is your time to take action to purchase health insurance.

Here is how you can take advantage of this sign-up period to secure health insurance and avoid any subsequent penalties.

What is Open Enrollment?

This is a period during which an individual can apply for health insurance with fewer restrictions than any other time during the year. It is important for those uninsured individuals to make note of this eligibility period. Open Enrollment for the calendar year of 2018 extends from November 1st through December 15, 2017. During Open Enrollment, insurance companies    waive underwriting guidelines and any requirement for evidence of insurability. When Open Enrollment ends on 12/15/17, individuals seeking coverage need to be “qualified” for Special Enrollment, or they will be required to wait until the next scheduled open enrollment period for 2019.

What is Special Enrollment?

This is a period outside open enrollment during which you are given an exception and can purchase health insurance following a qualifying life event, including divorce, marriage, birth, adoption, moving, death and loss of employer sponsored coverage.

How can individual insurance be purchased?

A number of Health Insurance Companies are offering Individual health coverage either directly through health carrier websites, via the New York State Health Exchange, or off the Exchange through independent insurance brokers.

What penalties will you be responsible to pay if you are not covered?

In 2018: $695 or 2.5% of income (individual) and $347.50 (child). The maximum penalty will be set at $2,085.

Health insurance is extremely important for all individuals, even for those with a clean bill of health. Accidents happen, as do unforeseen illnesses.  The cost of emergency room visits, x-rays, MRIs, hospital stays and doctor visits can all add up and be a financial burden to you and your family. We urge you to take advantage of this opportunity to purchase health insurance.  Please contact us with any questions you have about Open Enrollment.

How Will Purchasing Life Insurance Benefit Your Family?

Family dog

As part of Life Insurance Awareness Month, we would like to take this opportunity to shed light on the valuable benefits of purchasing life insurance. This is a chance to ensure your family is protected, accommodated, and comfortable in the event of your absence. Allow us to share some of the ways life insurance can take care of your family and potentially mitigate pressing expenses.

Income Replacement: If you’re the primary earner, your family depends on your livelihood. Life insurance can help your family cover the costs of expenses such as:

Mortgage: A mortgage may prove to be difficult to pay for as your family transitions to living life in your absence. The death benefit could help cover this cost while they adjust.

College Expenses: The death benefit could help cover tuition expenses for your children. It may take your spouse some time to find a job in your absence. Even then, there will be other expenses to account for and this benefit would allow your children to continue college with a smoother transition after their mourning period.

Family beachChild Care: If your spouse must work additional hours in your absence to supplement income or require assistance watching over young children, there may be a need for child care services. The death benefit can help pay for this expense.

Final Expenses: Your life insurance can also cover expenses related to your death, including:

  • Funeral
  • Burial
  • Last Rights
  • Medical expenses you leave behind that may not have been covered by health insurance.

Life insurance will offer your family some peace of mind while going through this sad and difficult time. Everyone’s situation is different, so feel free to contact us and we can tailor a plan that best fits your family’s needs in your absence.

Have You Considered A Job In The Insurance Industry?

Job Interview 2

Congratulations! You’ve completed your collegiate career and are excited to use what you learned and embark on a new career. Celebrate your accomplishments! You have earned it!

As you enter this amazing time in your life and reflect upon where the next road leads, we encourage you to stay positive during what can be an overwhelming and challenging time.

As an ambitious professional looking to dive in head first and get real world experience, where can you turn?

We are here to share with you the many rewarding and lucrative areas of the insurance industry!

There are so many possibilities the insurance industry can offer with your versatile talents.

Check them out!

  • Customer service
  • Claims
  • Underwriting
  • Management
  • Marketing
  • Information Technology
  • Social Media
  • Human Resources

In addition, there are many perks to working in insurance.

• With various careers and respective roles to choose from, you will find of plenty of room for creativity, growth, and stability. Companies are often looking for young, energetic talent to train, nurture, and develop to help fill these roles.

• Insurance will be around forever! Insurance will always be needed regardless of the economic climate, so there will always be a place for you! Therefore it will provide ambitious individuals with the groundwork for job security. With varied roles to fill, you are bound to meet co-workers with diversified talents and personalities. No work day is ever quite the same.

• Most rewarding, you will come away with a sense of purpose. You’ll be part of an industry dedicated to helping people protect themselves, their assets, and their families in hopes of securing the best future and overall quality of life.

With all of this to look forward to, what are you waiting for? Visit our career page to stay on top of the opportunities we may have for you moving forward!

New York Paid Family Leave Law: Key Information, Dates and Reminders

Newborn with parents

New York’s new Paid Family Leave (PFL) law will go into effect on January 1st, 2018. This is a mandatory benefit for all New York employees, and employers have the option to approach their employees to make early deductions. Beginning July 1st, 2017 employers can start making these deductions. In the interest of sharing more information, Petschauer Insurance would like to answer some pressing questions to help readers understand how this law impacts you.

What is PFL & who qualifies for this benefit?

PFL supplements part of an employee’s income while they are out of work. Full-time employees who have worked 26 consecutive weeks and part-timers who have worked a minimum of 175 days are all eligible.

When can you take PFL?

Paid Family Leave can be taken for newborn bonding and/or foster adoption (within one year of birth/placement), the caring of a seriously ill family member, or family exigency/military leave. The need for exigency leave will arise if a covered military family member is on covered activity duty or active duty status.

How much will PFL pay?

In 2018, employees will be eligible for 50% income replacement for a maximum of 8 weeks. An employee’s approved time off and income replacement percentage will continue to increase through 2020.

How much will PFL cost?

Employees fund PFL through payroll deductions. The premium or contribution will be equivalent to .126% of an employee’s weekly wage, capped at $1.65 per week for New York’s average wage of $1,305.92.

Will you have job protection?

All eligible employees have job protection while out on Paid Family Leave.

Have more questions about Paid Family Leave? Please contact us today! 

Celebrating Our 2016 Content This Holiday Season

cartoon-santa-dog

The holiday season is one filled with laughter, songs, good food and even better company. As you celebrate with family and friends, we wish you happy holidays and hope that you create wonderful memories together.

The forthcoming new year also provides all of us an opportunity to reflect back upon the highlights of the past twelve months. As we do, join us in looking back at some of our favorite blogs and a special video from 2016. Once again, happy holidays from all of us at Petschauer Insurance.

  1. Travel Insurance for your Dream Vacation
  2. What You Need To Know When Choosing A Health Insurance Plan
  3. Certificate Of Insurance 101: What Business Owners Need to Know
  4. Key Man and Buy Sell Insurance Simplified
  5. How is your car insurance rate determined?

Understanding the ACA Obamacare Tax Penalty For the Uninsured

health-insuranceWhen filing your 2016 tax returns, you could face a sizeable fine if you and/or your family are without health insurance.

The Affordable Care Act mandates that anyone that has gone without health insurance for a span of three months or more is subject to paying a fine. The penalty this year has increased to equal the greater amount of $695.00 or 2.5% of an adult’s income. For every child under 18 without health insurance, the penalty is half that of an adult’s.

This penalty is deducted from any income tax refund you may be eligible for. It would be unfortunate to be burdened by such a penalty and have it get in the way of the potential tax refund you look forward to receiving every year.

There are, however, exceptions to the rule.

You may qualify for an exemption if you fall under any of the following categories:

  • Individuals and families who fall under the income-tax federal threshold would be exempt, or receive the necessary subsides to offset the costs of the health insurance.
  • If you are unemployed and are unable to find coverage costing less than 8% of your adjusted gross income, you would be exempt from penalties as well.
  • You may also qualify for a hardship if you are homeless or have been evicted in the last six months.

We encourage you to review this information carefully so that you can make good decisions for you and your family.

Please note, Open Enrollment for 2017 begins on November 1st  2016.  Feel free to contact us today to discuss the options that best fit the needs of you and your family, as the penalty will be the same for next year.

What You Need To Know When Choosing A Health Insurance Plan

What You Need To Know When Choosing A Health Insurance Plan

Is this the first time you are presented with the option to purchase your own health insurance?

Let us help you get started by defining some of the most misunderstood health insurance jargon along with 6 categories to pay close attention to when selecting a plan.

1) Network: This outlines the group of hospitals and doctors being offered to you by a particular insurance company; including primary care physicians and specialists.

2) Type of Plans:

    a) HMO (Health Maintenance Organization) plans cover medical care provided by doctors and hospitals inside a specific network. HMOs often require members to get a referral from their primary care doctor before going to see a specialist.

    b) EPO (Exclusive Provider Organization) plans allow you to access doctors that are only included in your specific network, and generally do not need referrals before going to see a specialist.

    c) PPO (Preferred Provider Organization) plans allow you access to doctors and hospitals inside and outside of your selected network and are typically the most expensive plan option.

3) What Tier to Select: Plans are categorized in four tiers.

    a) Platinum: Most expensive plan with little or no deductibles.

    b) Gold: Less expensive than Platinum plans with relatively low deductibles.

    c) Silver: Even less expensive premium with high deductibles.

    d) Bronze: These plans have the lowest premium and the highest deductibles.

4) Before benefits are paid, here is what you are responsible for:

    a) Your Deductible: The set dollar amount you have to pay before your insurance “kicks” in.

    b) Your Co-Pay: The set dollar amount you will have to pay Primary Care Physicians & Specialists at the time of your appointment.

    c) Your Co-Insurance: Set percentage for certain services you need.

5) Be aware of your out of pocket maximum.

This is the total dollar amount you will be responsible for in a given period, either a calendar year or contract year. This amount will include your deductibles, co-insurance, & co-pays. Once you have reached this amount in your given period, your medical expenses will be covered 100% until the end of that period. At that time, it will start all over again. Please note, you will always be responsible for your premium payments.

6) Prescription Drugs: they are generally broken down by 3 tiers

    a) Tier 1– generic drugs subject to the lowest co-pays

    b) Tier 2– brand name drugs subject to higher co-pays

    c) Tier 3– non-formulary drugs subject to the highest co-pays with some plans even having a deductible or limit within this

Hopefully, we have provided you with a basic understanding of health insurance so that you are able to make a more informed decision. Open enrollment for 2017 begins November 1st. Feel free to contact us today to help you make the choice that best fits the needs and budget of you and your family.