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What is “actuarial value” in health insurance?

The Affordable Care Act reformed the insurance industry by requiring better policy coverage for consumers. The law sought to ban flimsy policies that provided far less protection than was needed for prices that far outweighed their value. Congress weighed facts and evidence about cost sharing in major medical coverage among large groups and public employees. […]

What is a gap health insurance plan?

In recent years health insurance costs have skyrocketed. The Affordable Care Act was designed to decrease the cost of health insurance for all Americans, but premiums have continued to increase in cost. Many people qualify for a subsidy, but if you don’t the burden of health insurance is a huge financial restraint for many. With […]

How to Read Health Insurance Policies

The most effective way to use your health insurance is to understand it. The Affordable Care Act (ACA) has worked to simplify the health care system, but understanding your policy is still difficult, especially when you don’t understand the lingo. To help you get the most out of your insurance, we’ve described several ways to […]

What are narrow networks in health insurance?

Narrow networks are part of the trends in healthcare to trim expenses and focus the delivery of services on high-value medical providers. Most plans on the Obamacare Exchanges in 2017 have narrow networks; they consist primarily of HMOs with no outside network cost sharing. HMOs restrict consumers to their network providers and do not offer […]

How long does it take to get health insurance coverage?

When shopping for health insurance, you probably have a ton of questions. For instance, you’ll want to know how much your premiums are, what’s covered, and what doctors are in your network? Another important question that people forget to ask, which is critically important is when will your coverage go into effect. When you enroll […]

How often do you have to pay health insurance?

The individual mandate requires that every eligible person gets and keeps qualified health insurance coverage. The insurance contract is an agreement with a stated premium payment. Health insurance contracts revolve around payments. The initial payment of premiums is the contractual trigger for beginning coverage. The first payment has legal significance in terms of the insurance […]

What is a “lifetime maximum benefit” in health insurance?

The lifetime maximum benefit provision was a standard feature of health insurance contracts before the Affordable Care Act of 2010. These provisions placed a dollar limit on the amount an insurer would pay for a specific benefit. Once reached, the cap or limit would block further payments for the lifetime of the insured. Insurance companies […]

What is HIPPA?

HIPAA is often considered to be a landmark piece of healthcare legislation. It is split into two parts, called Title I and Title II. HIPAA was passed in 1996 and signed into law by Bill Clinton. Title I covers health insurance coverage for people when they lose or simply change jobs. Title II covers what […]

When can you start using your health insurance?

With many people having the mistaken belief that their health insurance policy is valid the day that they sign the contract, this article aims to set the record straight. Here are a few basic principles to help you better understand this topic before we dive into the finer details. If you’re looking for health insurance, […]

What is a third party administrator in health insurance?

The health insurance field can be difficult to navigate, and this is particularly true for many companies around the country. It is important to offer health benefits to employees in order to attract the best talent, but it can also be extremely cumbersome to manage all of policies and regulations that go with it. These […]

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