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Defined Contribution Health Plans

In addition to all the noise going on in the health insurance industry over Health Care Reform (aka Patient Protection and Affordable Care Act, aka ObamaCare), there’s an increasing trend amoung small employers to ‘define’ what they will pay for health benefits to a fixed amount and let their employees purchase their own coverage. The advantages of this approach include:

  • Lower the cost of your current group plan without reducing benefits
  • Allows you to transition to individual insurance options which are much lower in cost than group
  • Helps employee’s pay premiums on a pre-tax basis, even for individual health coverage

To learn more contact Doug Helser at 614-834-6624 today or click here.

Individual Health Insurance Buyers Guide


The attached is a nice basic orientation of what health insurance and state programs are currently available to individuals and families in the Ohio marketplace.

Lifespan Calculator

September is Life Insurance Awareness Month and this little tool, developed by Northwestern Mutual illustrates how long you will live based on 12 easy lifestyle questions. Give it a whirl – you may be surprised how long you may live.

Health Care Reform Subsidies – Do You Qualify?

There’s a great tool available to see if you qualify for a premium subsidy under the PPACA (Health Care Reform Law) – go to

A New Beginning

Effective August 1, 2012, I am joining the Mark Matthews and Associates Insurance (MMA)  agency in Pickerington. Mark has built a nice local Propery and Casualty business with an excellent staff, great carrier contracts and a strong work ethic – all of which I was immediately drawn to. Plus he is heavily involved in the local community serving as Vice President of the Violet Festival (being held this weekend) and is immediate past president of the Pickerington Chamber of Commerce.

For my part, I am bringing 29 years of Health, Tax-Savings Plan Administration and Life expertise to MMA’s current clients and contacts, especially as it relates to ObamaCare and how to plan for these changes to our health insurance delivery system. If you are a small employer, an individual sole-proprietor or just a curious consumer who wants to know exactly how this reform affects you personally, contact me today for a quick check-up on your options.

My new office number is 614-834-6624 and email is

Looking forward to seeing you soon!

The Worst Case Scenario

With the Supreme Court’s pending ruling on the new Health Care Reform Law (aka – PPPACA, aka – Obamacare, aka – Patient Protection and Affordability Care Act) the 3 possible scenarios are shaping up to cost the consumer (that’s YOU!) more. These ourtcomes include:

  1. The Law is Ruled Constitutional – The new ‘exchange platforms’ in each state will add millions of new customers for the insurance carriers. This would, however, decrease the individual marketplace by as much as 25%, while average individuals premiums stay about the same. Group premiums, in theory, would stablize, but the additional tax burden of subsidies, increase in Medicaid participants and decreases in Medicare reimbursements will hurt the end-user (that’s YOU!)
  2. The Individual Mandate is Ruled Out, but the Remaining Law Stays – New exchanges would add an estimated 5 million new enrollees. However, because of the guarantee issue component (effective in January 2014), this will increase group premiums as much as 25%. The individual health market rates will also increase by approximately 10%.
  3. The Entire Law is Ruled Unconstitutional - Health premiums for both the group and indivual markets would remain about the same.

What’s the most likely outcome in our opinion? Number 2 – The Worst Case Scenario! No individual mandate means:

  • The insurance carriers will not collect enough premium to offset the looming claims of the 5 or so million who will enroll as provided by th exchange guarantee issue provision.
  • More Claims = More Premium!
  • The subsidies, which remain in effect,  will add substantial additional costs to the social program dollars that it is not sustainable.
  • Group premiums will explode by another 25% or more
  • $700 Billion will be added to Medicaid enrollments and $700 Billion will be cut from Medicare reimbursement schedules (guess who pays more again? -YOU)

What can YOU do now? It’s only a few more weeks before we get the final ruling, but be prepared more for the worst case scenario by checking out how we save our customers thousands of dollars on their own premiums and out-of-pocket medical expenses.



My Top Five Health Insurance Savings Strategies

Having insured hundreds of individuals and employers over the last 29 years, I have identified my top five strategies for saving money on your health insurance dollars.

1) DO THE MATH – consumer-driven high deductible health plans are the most affordable premiums in the market, plus they provide tax-free reimbursements for out-of-pocket expenses. When you compare the annual cost of these plans to more traditional PPO plans with co-pays for prescriptions, office visits and emergency room care, you can usually fund most, if not all, of your HSA (Health Savings Account) or FSA (Flexible Spending Account) with the premium savings. Then you can enjoy lower fixed costs and tax savings on incurred expenses.

2) STOP BUYING BRAND MEDICATIONS – for nearly every FDA approved brand drug there are at least three generic equivalents. Ask your doctor to provide generic options and/or vitamin supplements for your medications. When we moved from a traditional PPO plan with a drug card to a HSA, I asked my doctor for alternatives to two popular brand medications I was on at the time. The difference was dramatic – we went from a quarterly cost of over $830 for two brand medications to less than $25 – a savings of over $3200 a year!

3) LOOK AT FUNDING ALTERNATIVES – for many employers implementing a higher deductible health plan and a HRA (Health Reimbursement Arrangement) that only reimburses the back-end of the deductible is a great way to reduce premiums and still maintain an affordable plan for your associates.  For example, by moving from a $1,000 deductible plan to a $5,000 deductible you can save as much as 20% off the premium. Statistically, only 15% of a groups population is going to max out on their deductibles in a given year, so you can set up a deductible bridge to cover the second half of an employees exposure. It usually works out as a win-win, because the employer and the employee save on their monthly premiums and the employer saved enough premium to be able to reimburse the few that will incur the large deductible exposure. You can also fully insure the HRA through a program called ‘Premium Saver’, which saves premium and limits an employers potential exposure to self-funding a HRA plan. For more information on ‘Premium Saver’ visit

4) BUY PRODUCTS THAT LOCK IN PREMIUMS – Voluntary indemnity plans through Aflac offer tax-free reimbursements for specific causes like accidents, hospitalizations, critical illnesses and disabilities directly to the insured. The best feature of the indemnity plans is the premiums lock in at your enrollment age and do not trend up annually. Plus the coverage is portable. By combining high deductible plans with Aflac coverages you can save on fixed premiums and still pay for unforseen out-of-pocket expenses tax-free. These plans work especially well with HSA plans when employees cannot afford to set aside thousands of dollars for their deductibles.

5) ADOPT WELLNESS PROGRAMS – change is not always good except when it comes to improving your health. There are a myriad of lifestyle and wellness programs available through both the insurance carriers and stand-alone in the market, including: smoking cessation, weight-loss and nutrition plans. I especially like YouRQuest Wellness Solutions as a provider because they work with individuals, corporations and are independent of a specific carrier. Learn more about them at  Additionally, individuals can greatly improve their health and start a work-at-home business with companies like Advocare that promote products for weight-loss, balanced nutrition and training activities. For more information on Advocare click here

article submitted by Doug Helser of Ohio Insurance Associates


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