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Limited Benefit Plans for Employees and Individuals

What is a limited medical benefit plan? What are the different types of limited benefit plans? How can we evaluate a limited benefit plan?

Health Care Crisis

In today’s marketplace, owners of business acknowledge the fact that all employees expect and want some sort of medical insurance coverage. Benefits have been a major contributing factor in retention of employees and reduction in their absenteeism and turnover. Every blue collar, hourly, part-time or self employed person is seriously in need of medical benefits.

However, due to restricted income, and with present premiums for covering the family hovering around $2,400 every month, it is getting out of reach, jeopardizing the safety of family health care in serious jeopardy. For people who do not have any job the situation is just unattainable. Our Government on the other hand is unable to provide any realistic solution.

These are good enough reasons to explain why approximately fifty million Americans are still without health insurance.

Limited Medical Benefit Plans Explained

Limited medical benefit plans or mini-medical plans are available at economical cost and provides and alternative to comprehensive and expensive reputed medical insurance plans. We can call them trimmed down copy of superior medical plans and can be provided to the employers as well as to individuals. One can use them either as a supplemental or primary insurance coverage.

The benefits of limited medical benefit plans are not based on original expenditure incurred by the patient but on a definate indemnity amount as the insured person utilize various services related to health care. There is, however, certain “co-pay” that does pay on the basis of specific expenditure incurred and no benefits from indemnity.

Limited medical benefit plans has been gaining acceptance in individuals, employers, and the healthcare industry as well. Features and benefits of this plan can be found in USA Today, Wall Street Journal, The New York Times, and several newsletters published throughout the country.
Skyrocketing healthcare costs with no end is seen has forced many insurance companies to switch to limited medical benefits from major medical plans. Individuals, working people and employers prefer this plan as it carries benefit for every dollar.

In today’s marketplace employers, individuals and insurance agents have no idea how to identify and search for quality limited medical benefit plans. It is really a tedious task to find which limited benefit plan has the most effective design and/or level of commission. People are also unsure about the quality of administrative services and the customer base offered by limited benefit plan insurance carriers.

The Benefits of Limited Medical Benefit Plans

The health insurance industry has given cost conscious employers and employees a breather in the form of limited medical benefit plans. This innovative new concept has enabled many individuals and employers to enroll in some sort of health care plan and it has become the fastest growing component in the insurance industry.

Some of the benefits to associations, employers and agents for enrolling in limited medical benefit plans are as follows:

  • Guaranteed Issue – every applicant or employee is accepted irrespective of his or her condition.
  • Pre-existing Condition Clause – this may or may not be waived depending upon the carrier. Majority of limited benefit plans waive the pre-existing condition clause, which makes it the only insurance plan that covers all the conditions immediately after enrollment.
  • Flexible Contribution is required from the employer. In most of the cases employers are not required to contribute anything and it is 100% paid by the employee.
  • Flexible Participation and Eligibility – The participation requirement for limited benefit insurance plan can, at times, be as little as 1% or even no requirements for participation.
  • Flexible Billing Options – These include paper billing, electronic billing, self or list bills, billing for different payroll deduction periods.
  • Flexible Enrollment – There are various ways by which a person can enroll in limited benefit plans such as through internet/web enrollment, in person meetings, telephonic, one-on-one, or group meetings.

Evaluating a Limited Benefit Medical Plan

It is important to go through all the elements of different limited benefit medical plans. For example, an employer or employee should consider the limitations in the plan related to pre-existing conditions, limitations on deductibles, exclusions within the plan exclusion contract, co-insurance and/or indemnity benefits.

The packaging of a limited insurance plan may look very enticing, but as you pull off the wrapping you may find many hidden limitations and exclusions. It is therefore imperative to go through the insurance contract and other related documents thoroughly before you sign up for the enrollment.

Where and How to Enroll in Limited Benefit Plans

It is often very difficult to find a reliable insurer of limited benefit health insurance, the plan designs they have, their respective premiums and rates, and how they are different from others. Whatever may be your query related to limited benefit insurance under the sun, just fill in the above given form and one of our local, licensed agent will contact you as soon as possible.

Companies who are looking forward to enroll their employees in limited benefit plan must consider all the aspects of implementing the plan. Our agents have years of experience and an adequate amount of knowledge to answer all the queries to your satisfaction.

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