- Assignable Benefit – A way or method an insurance plan is designed to pay benefits. Assignable benefits pay directly to the doctor or hospital rather than directly to you. This is the most desirable method of payment since it eliminates the need for you to be involved.
- Carrier – The insurance carrier assumes the risk on an insurance plan. They provide the benefits of the plan and issue payment for claims.
- Certificate of Insurance – The document issued by the insurance company including the effective date, type of insurance coverage purchased, the specific coverage amounts of your plan and schedule of benefits. It’s important to review your Certificate of Insurance fully upon purchasing your plan.
- Claims – The formal request a doctor or hospital submits to an insurance company to receive payment for the services they provide to an insured person.
- Deductible – The dollar amount that must be paid before the insurance company will pay their portion of the benefit.
- EOB – Short for “Explanation of Benefits”, an EOB is the statement an insurance company issue to the planholder explaining what medical services they paid a benefit for. An EOB is not a bill but rather a summary of the claims received and benefits applied according to your schedule of benefits.
- Excess Benefit – The term defining the specific order for which a benefit is to be paid. An excess benefit will pay last, after all other eligible benefits have been paid out.
- Guaranteed Acceptance – An insurance term meaning there is no “review period” before the applicant is approved.
- Indemnity – A style of insurance plan that pays a set dollar benefit for a specific procedure or service.
- Surgical Schedule – A list of surgical procedures, often in excess of 5,000, and the insurance benefit available for each.
Category Archive for: ‘Core Health Insurance’
Ten Health Insurance Terms 0
Get to Know the Customer Login 0
After you’ve enrolled in a SASid insurance plan, take advantage of what your customer login account has to offer:
- View/Print Plan Documents
- Make Payments
- View Claim Status and EOBs
Step One: Login
The first step in accessing your customer account is to login here. You will be asked to enter your username and password. 
Your username is the email address you used with enrolling into your SASid insurance plan. Your initial password was randomly generated and sent to you just prior to your enrollment. If you cannot remember your password simply enter your email address in the box below “Forgot your password?” and click “Request Password”. A new password will be sent to you via email.
Step Two: Navigate Your Account
Once logged into your account, you’ll find a row of tabs towards the top of your login screen which includes: Home | My Quotes/Plans | My Profile | Inbox | Logout. Here is a brief explanation of what can be found in each section.
- Home – will take you back to the original screen you came to upon initial login
- My Quotes/Plans – allows you to view any/all quotes and plans you have with SASid. This will include Active, Incomplete, and Canceled plans
- My Profile – update your mailing address, email address, and phone number
- Inbox – shows enrollment confirmation emails, declined payment emails, and any other important correspondence pertaining to your SASid insurance plans
- Logout – will securely log you out of your SASid customer account
View Plan Documents
Under the “My Quotes/Plans” tab you’ll find any SASid insurance plans you’ve enrolled in. Click on the GREEN link below the plans documents you’d like to view to open the plan details page.
Click the GREEN Link
You’ll then be taken to a page showing more details about your plan including the Plan Number, Effective Date, and Plan Type. To the right of those details is a drop-down box. Clicking on the drop-down button will open the plan documents available for your viewing and printing. To view, select the document and click the “Open” button to the right.
Click Drop-down
Make Payments
Also under the plan summary page you have the ability to make premium payments and change your payment method. Click the “Payments” tab under the plan logo to view payment service options. From here you can make a payment or change the method from which your future payments are made.
Click the "Payments" tab
View Claims and EOBs
To view claims, click the “Claims” tab then click “View Your Claims” (both highlighted in yellow in the image below). This will allow you to check the status of any claims received by InsuranceTPA.com and to view their corresponding EOBs.
Click "View Your Claims"
Know your Core Health benefits: Wellness Office Visits 0
Our experience indicates that members who understand their plans retain them longer. With a good understanding of each benefit you’ll be able to maximize value while minimizing your out-of-pocket costs.
Core Health plans have a Wellness Office visit benefit which pays a preset dollar amount, indemnity benefit. The current Wellness Office visit benefits range from $100 to $125 per visit (highest levels in the market) depending on the plan selected. Each plan includes 2 Wellness Office visits, per covered person, per plan year. A Wellness Office visit is payable for a routine medical examination by a licensed physician.
A Wellness Examination is an evaluation of the body and its functions using inspection, percussion (tapping with the fingers), and auscultation (listening). A complete health assessment also includes gathering information about a person’s medical history and lifestyle.
A Comprehensive Physical Examination provides an opportunity for the healthcare professional to obtain baseline information about the patient for future use, and to establish a relationship before problems happen. It provides an opportunity to answer questions and teach good health practices. Detecting a problem in its early stages can have good long-term results.
Proactive lifestyles are healthier ones. Having routine exams is simply one of, if not, the best ways to head off disease and illness. Stay organized and remember to schedule routine physical exams for you and your family members. This can greatly increase your chances of catching the onset of disease at an earlier stage. This means treatments for early diagnosed disease can begin sooner, which almost always means a more favorable outcome.
To learn more about the benefits of your plan, contact InsuranceTPA.com at 800-279-2290. InsuranceTPA.com is the plan administrator for Core Health Insurance. Already a member? Login to your account here.
Know your Core Health benefits: Doctor Office Visits 0
Our experience indicates that members who understand their plans retain them longer. With a good understanding of each benefit you’ll be able to maximize value while minimizing your out-of-pocket costs.
The Core Health plan you selected has a doctor office benefit which pays a preset dollar amount, indemnity benefit. Office visit benefits range from $100 to $125 per visit (highest levels in the market) depending on the plan selected. The benefit is payable to a provider for a doctor visit related to an eligible sickness/illness. There is a 30-day waiting period starting from your plans effective date for the doctor office benefit.
While this benefit will pay towards your visit with any doctor in the country, seeing a doctor in Core Health’s provider network allows you access to significant saving in addition to the insurance benefits of your plan. Doctors and hospitals in this network have pre-negotiated savings for specific services and procedures. Using a network provider will allow you to take advantage of these savings and make the indemnity benefits of your plan stretch farther. In many cases, when the office charge is less than the benefit of your plan, you will receive a check for the difference. Another reason it “pays” to be a Core Health member.
To learn more about the benefits of your plan, contact InsuranceTPA.com at 800-279-2290. InsuranceTPA.com is the plan administrator for Core Health Insurance. Already a member? Login to your account here.
Obsession with value prompts Core Health upgrades 0
With the one year anniversary of the Core Health redesign just around the corner, what better way to celebrate than by releasing a significant plan upgrade? We’ve spent the last twelve months bringing these plans to our distribution partners and have sparked an overwhelmingly positive response. Starting June 1, 2011, Core Health plans will have indemnity benefits for 10 Office Visits – an increase from 5 Office Visits on the previous plans. This benefit increase comes from our longstanding desire to provide members with the most benefit possible, at a rate that allows them access. SASid understands that your clients’ experience determines your retention. We will continue working on ways to bring Core Health value, in turn increasing your retention and client satisfaction.
Take advantage of a new partnership through Take Care Clinics and the benefit could line your pockets! 0
“It pay$” to be a customer of Core Health Insurance when using a new partnership through Take Care Clinics.
SASid Inc, has partnered with Take Care Clinics®, which is a subsidiary of Walgreens®, and is a network of health and wellness companies committed to providing affordable, accessible, timely, and high-quality healthcare. Effective May 1st, 2011 SASid, Inc will launch new limited medical indemnity benefits (through Core Health Insurance plans) which provide generous indemnity benefit amounts for an office, lab, and wellness visits. Take advantage of this new benefit and the low cost of the Take Care Clinic and you’ll be reimbursed for the savings.
Benefits of Take Care Clinics:
- There are more than 350 Take Care Clinics® at select Walgreens® throughout the country. You can do a search here..
- Each of the clinics are open 7 days a week to provide simple, quick, affordable access to high-quality healthcare for adults and children.
- Walk in treatment available – you do not have to make an appointment; just walk in.
- The best part – often the Core Health Insurance benefits are greater than the cost of treatment. This results in an excess benefit reimbursement check to the client.
What Take Care Clinics® treat?
- Vaccines – Flu, Hepatitis A &B, Chicken Pox, Shingles, Meningitis, HPV and more.
- Physicals – Camp, School, and Sports
- Screenings – Blood Pressure, Health Screening, Influenza A & B, and more.
- Illnesses – Allergies, Bladder Infections, Breathing Treatments, Bronchitis, Cold, Cough, Flu, Ear Infections, Pink Eye, Sinus Infections, Sore Throat/Strep Throat, Upper Respiratory Infections, and more…
- Minor Injuries – Abrasions, Animal Bites, Minor Cuts, Splinter Removal, Sprains/Strains, and more..
Following is an example of how “it pay$” to go to a Take Care Clinics® using a Core Health Insurance plan.
* $69.00 Office visit rate based on Illness, Injury, or Skin treatment exam as of 4-20-2011 found at: www.takecarehealth.com/Cost_Menu.aspx. Rates may vary based on location and or complexity of the exam. Services are subject to the Limitations and Exclusions of the policy.
Provider network delivers even more benefit…
Did you know? Take Care Clinics are within the Beechstreet Preferred Provider Option (PPO) network and therefore an office visit would be eligible for the PPO discount which can increase the amount of savings and reimbursement check to insured.
SASid is dedicated to continual research of added value benefits and services to the Core Health Insurance portfolio. This creates happy satisfied customers and best in class retention. Please contact SASid if you have any ideas, questions, or feedback that will help add value in the future.
Core Health Insurance Changes Favorable Due To Health Care Reform 0
We’re proud to announce that even with the positive Health Care Reform Changes (below) we are not increasing the premium rates for Core Health Insurance (CHI) for the next year.
The changes will take place for dates of service incurred on or after May 1, 2011 for all existing clients and new members moving forward:
- The eligible dependent child age will increase from 24 to 26.
- All benefits will be paid as per the amounts listed in your current Schedule of Benefits which may be higher in some cases than the “up to” payout amounts previously paid. This means that if a client has a claim submitted for a specific benefit, the plan will pay the full benefit amount, even if the charge is less than the benefit amount. The provider is paid directly, and then any difference is sent directly to the insured.
- The doctor office visit co-pay benefit will be replaced by an indemnity (flat dollar) amount for a doctor visit benefit, which is a flat dollar amount. This amount should provide very similar out of pocket expense as stated above, however, that expense may be higher or lower depending on the plan you enrolled into (Physician, Value, Gold, and Platinum). A client’s out-of-pocket expenses will almost always be less when they visit a doctor in the Beech Street network.
Example: Previous visit to the doctor: The client was responsible for a $30 co-pay. Current benefit change means that when the client visit the doctor, the claim is sent to our claims department and re-priced, and then the plan will provide a flat benefit ($100 Physician, $110 Value, $120 Gold, and $125 Platinum). The doctor will be paid directly. If the benefit amount exceeds the charge, the client will receive a check for the difference. If the charge exceeds the flat benefit amount, the client will be responsible for the difference.
Core Health Insurance – Understanding your new office visit benefit
Making Lemonade out of Health Care Reform 0
There’s no denying that Health Care Reform (HCR) has dealt a massive blow to the individual health insurance distribution channel. Many brokers are pondering their future in the business today. Various HCR items have created challenges, including; mandated lower commissions, higher premium rates, guaranteed issue rules, unavoidable media discussion of Obamacare which has created a public with unrealistic expectations. With all of this doom and gloom on the horizon for the brokers marketing individual major medical plans is there a way to make lemonade out of lemons?
National Health Interview Survey, January – September 2009
HCR has also created significant opportunities in the marketplace for brokers to not only survive but flourish. Major Medical policies are expected to double if not triple in premiums by 2014 due to HCR‘s changes. We all have heard about the 46 million uninsured people in America today which is growing significantly. Why is it growing? HCR was supposed to help… Is it because people cannot access coverage due to preexisting conditions or is it because they cannot afford coverage? The reality is; the majority of the uninsured’s in America want and need Major Medical insurance but they cannot afford it. Many times brokers will provide Major Medical quotes to clients only to see them leave angry due to high cost. Brokers need to ask themselves are we doing our clients a service by advising them only to purchase Major Medical if a large portion of the population cannot afford it? Is it better that they do not purchase coverage at all or is it better they have a plan which provides limited coverage? The answer is pretty clear and even the government conceded and created a waiver system for limited medical plans due to the large number of participants. If they didn’t the uninsured population would increase once again. The uninsured marketplace is growing and they are interested in having some sort of coverage even if it is limited. The brokers who embrace this opportunity and understand that offering a lower costing alternative plan like limited medical indemnity will not only help clients but will survive HCR and flourish in the future to come.
Limited Indemnity Medical policies offer a valuable alternative to those who cannot afford Major Medical coverage. Sales have grown substantially this past year for those brokers who understand how these plans can help. If you are one of those brokers who have stubbornly avoided these plans you better take another hard look at them. It is true that some of these plans (organizations) are not designed to offer a good value to the consumer (designed only to make money and deceive); which is why many brokers have avoided them in the past. Don’t believe this is the case with all Limited Indemnity Medical plans; some offer significant value for the cost and it is important to analyze and pick the best partner which markets and administrates them.
Here is our pitch… Core Health Insurance plans are designed to offer value and help people. Value is easy to sell, administrate, and retain. Plus, you can feel good understanding that you were able to help them with their needs. They are affordable starting at $91.78 a month and Guaranteed Issue for those who have been denied major medical. So next time you offer Major Medical and they do not purchase anything; you need to ask yourself if you have helped your client. Is it better to have something rather than nothing?
