Frequently Asked Questions

What is auto insurance?

Auto insurance protects you against financial loss if you have an accident. It is a contract between you and the insurance company. You agree to pay the premium and the insurance company agrees to pay your losses as defined in your policy.

What is bodily injury liability?

This coverage applies to injuries that you, the designated driver or policyholder, cause to someone else. You and family members listed on the policy are also covered when driving someone else’s car with their permission, this is referred to as Drive Other Car coverage.

Why is it important to have adequate limits?

It’s very important to have enough liability insurance, because if you are involved in a serious accident, you may be sued for a large sum of money. Definitely consider buying more than the state-required minimum to protect assets such as your home and savings. You may give us a call and we would be happy to answer any questions about state minimums, or what protection would be the right fit for you.

What is medical payment or personal injury protection (PIP)?

This coverage pays for the treatment of injuries to the driver and passengers of the policyholder’s car. PIP can cover medical payments, lost wages and the cost of replacing services normally performed by someone injured in an auto accident. It may also cover funeral costs.

What is property damage liability?

This coverage pays for damage you (or someone driving the car with your permission) may cause to someone else’s property. The majority of the time, this means damage to someone else’s car, but it also includes damage to telephone poles, fences, buildings or other structures your vehicle may hit.

What is collision coverage?

This coverage pays for damage to your car resulting from a collision with another car, object (such as a deer) or as a result of flipping over. Even if you are at fault for the accident, your collision coverage will reimburse you for the costs of repairing your car, minus the deductible. If you’re not at fault, your insurance company may try to recover the amount they paid you from the other driver’s insurance company. If so, you’ll also be reimbursed for the deductible.

What is comprehensive coverage?

This coverage reimburses you for loss due to theft or damage caused by something other than a collision with another car or object, such as fire, falling objects, missiles, explosion, earthquake, windstorm, hail, flood, vandalism, riot, or contact with animals such as birds or deer. This will also reimburse you if your windshield is cracked or shattered.

What is uninsured and underinsured motorist (UM/UIM) coverage?

UM/UIM will reimburse you, a member of your family, or a designated driver if one of you is hit by an uninsured or hit-and-run driver. Whereas, underinsured motorist is coverage when an at-fault driver has insufficient insurance to pay for your total loss. Feel free to contact us if you have any more questions regarding current state minimums and to discuss coverage’s in more detail.

What if I lease a car?

If you lease a car, you still need to buy your own auto insurance policy. The auto dealer or bank that is financing the car will require you to buy collision and comprehensive coverage. You’ll need to buy these coverage’s in addition to the others that may be mandatory in your state, such as auto liability insurance.

What is “gap” insurance for vehicles that I don’t own?

The leasing company may also require “gap” insurance. This refers to the fact that if you have an accident and your leased car is damaged beyond repair or “totaled,” there’s likely to be a difference between the amount that you still owe the auto dealer and the check you’ll get from your insurance company. That’s because the insurance company’s check is based on the car’s actual cash value which takes into account depreciation. The difference between the two amounts is known as the “gap.” On a leased car, the cost of gap insurance is generally rolled into the lease payments. You don’t actually buy a gap policy. Generally, the auto dealer buys a policy from an insurance company to cover all the cars it leases and charges you for a “gap waiver.” This means that if your leased car is totaled, you won’t have to pay the dealer the gap amount. If you have an auto loan rather than a lease, you may want to buy gap insurance to protect yourself from having to come up with the gap amount if your car is totaled before you’ve finished paying it off. Ask one of our friendly agents about what is the best fit for your needs.

How much liability coverage do I need?

Almost every state requires you to buy a minimum amount of liability coverage. Chances are that you will need more liability insurance than the state requires because accidents cost more than the minimum limits. If you’re found legally responsible for bills that are more than your insurance covers, you will have to pay the difference out of your own pocket. These costs could financially devastate a family. Increasing your liability limits is an expensive to way to better protect you and your family. However, sometimes just increasing your auto liability limit isn’t enough. Give us a call to speak to an experienced agent about if additional liability limits would benefit your personal needs. This is done through setting up a personal umbrella (Excess Liability) policy.

What does BIPD 20-50-25 and 20-40 UMBI mean on my auto policy?

BIPD means bodily injury and property damage coverage, in which insures you in the event that you are held liable for an accident. 20/50/25 means coverage of $20,000 per person to a maximum of $50,000 per occurrence for injury you may cause to persons, and $25,000 coverage for property damage (damage to the other car, mailbox, lamp post, etc. anything other than a person). 20/40 UMBI is UM/UIM coverage as stated above, where it covers $20,000 per person and $40,000 maximum per occurrence.

What are some ways that I can save money on my auto insurance?

Although there are a majority of factors that are out of your immediate control that play into what your insurance premium is, there are some ways that you can control the cost. A few of which are raising your comprehensive and collision deductible, reducing coverage on older or paid off vehicles, and also buying your homeowners and auto coverage from the same insurer. Although a lower price maybe a short term solution, you want to always remember that you don’t want to underinsure your self. Feel free to call us so that we may shop the top insurance companies and get you the protection you need at the price you deserve.

Does my insurance policy cover me if I am driving another person’s car?

This is a very common question and it depends on the “language” of the insurance policy. Most auto insurance policies will in fact cover any driver of the insured vehicle, unless that driver has been previously excluded from the policy, or the vehicle has been stolen. This would have to be proved with a copy of a theft report filed by the owner. If you are unsure whether your policy covers this, then don’t hesitate to call us, so that we may get you the correct answer. Usually insurance will “follow the vehicle” as far as coverage is concerned. The policy in force on the vehicle involved in an accident will cover the damage to the vehicle itself and provide the liability limits if other parties are involved. This coverage example assumes that you had the owner’s permission to drive the vehicle involved.

Does my child need to get insurance if they have a learner’s permit?

Generally speaking, yes, all drivers are required to carry insurance. Although it is a temporary license with certain restrictions, it comes with all the responsibilities of anyone who operates a motor vehicle on public roads. You can get your child his/her own policy or they can be covered under someone else’s, either way; they need to be a named on an auto policy.

Do I need separate rental car insurance?

Although this is a question that is brought up a lot, it is completely on a per policy basis. When you are looking to rent a car, we suggest you make two phone calls, one to us and another to the credit card company you will be using to pay for the rental cost. We would be happy to discuss if your policy has adequate limits and where the “gaps” in coverage may apply. In most cases, but not all, whatever coverage and deductible you have on your own car would apply when you rent a car, providing you are using the car for recreation and not for business. If you have dropped either comprehensive or collision on your own car as a way to reduce costs, you will not be covered if your rental car is stolen or damaged in an accident. Ask the attendant behind the rental car counter to see what coverage’s they can apply to your rental agreement and for how much each costs. If you run into any “snags” about policy language we would be happy to give you our professional opinion on which coverage’s would best fit your needs.

Does my car insurance cover me when renting a car abroad?

If you are planning to rent a car abroad, contact both your insurance agent and travel agent to find out what you need to do to be properly insured. If you are driving a rental car from the U.S. into Mexico, you may find more difficult to rent a car as U.S. rental car companies are increasingly concerned about the rising crime rates in that country. The minimum required insurance coverage to drive in Mexico is civil liability insurance which covers you in case you cause injury or damage. Your U.S. liability insurance is not valid in Mexico for bodily injury, though some U.S. insurance policies will cover you for physical damage—check with us to see if this applies to your policy. Another route would be that you could buy Mexican car insurance in several American border towns; there are generally several storefronts selling Mexican car insurance near the border.

Why should I buy home insurance?

Why should I buy home insurance?
Having the proper homeowner coverage is beneficial not only to the owner but also anyone that steps foot on your property. For the owner of the house this coverage will protect your house and personal property. Also, any guests on your property will be covered in case of an accident or injury through the liability portion of the policy.

How much home insurance do I need?

There are many things to consider when determining the limits of protection. The first is what would protect you if you lost everything. Having the proper coverage limits means you will have less to pay out of pocket if disaster strikes. One question you might ask yourself is “how much can I or my family financially afford to pay out of our bank account to pay the difference on a major loss?” Most people benefit greatly by being properly insured because if they were to lose everything, money is the last thing they are worried about. You will also need enough liability coverage to protect yourself from lawsuits resulting from your possible negligence. Another consideration is that your lender may require you to cover the house for at minimum, the amount of the mortgage. While some lenders might make recommendations as to who you should buy insurance from you are not required to purchase insurance from the banks recommendation and shopping online will generally always get you the best value. These are just a few of the things to consider when determining the limits of protection. For more information about how you can be sure you are properly insured please don’t hesitate to contact one of our friendly agents.

What determines the price of my home owners insurances?

Home insurance prices are determined by a number of factors: The type of construction and age of the building can be a big factor (a brick house usually costs less to insure than a frame house). Another pricing tool is to look at the number of fire departments and where the closest fire hydrant is. If you live in an area with little to no fire protection, you will generally pay more for fire insurance. There are many other things that can affect the price of you home insurance. Each company looks at certain risks a little differently and will price it accordingly. As brokers we are here to help you find which company works best for you to give you the protection you need at the price you deserve.

What is peril?

A peril is a condition that can cause a loss (ie. fire, theft, hail).

What deductible should I choose?

The deductible is the amount you have to pay out of your pocket on each claim. This only applies to the coverage on your house and personal property. A policy with a $500 deductible will cost more than one with a $2500 deductible. Higher deductibles also will generally result in fewer small claims and so they will have a lower premium. The right deductible for you might be determined by asking yourself “how much could I pay if I had a big loss?” If your answer is $2500 then you will save money on a monthly basis by having a lower premium. If your answer is only $250 then you will have a higher monthly premium but will be responsible for a great deal less if something happens.

What basic coverages are included in a home-owners policy?

The most common basic coverages are: property damage, personal liability, additional living expenses and medical payments. Other provisions and riders can be added as well. Below is the break down of a homeowners policy. Please note that while this is helpful in understanding the basics of a policy, all policies are slightly different. -Property Damage Property damage coverage is what covers your home and personal property when damaged by a covered peril. Most common perils include fire, windstorm, hail or lightning protection. It is important to note flood and earthquake are generally only covered when the coverage is added to your policy. You should carefully read your policy to determine exactly what types of losses will be covered. -Personal Property Personal property coverage includes the contents of your home and other personal belongings owned by you or family members. Generally your protection limit is equal to up to 50 percent of the value carried on your home. There are special exclusions placed on some personal property such as art-work, jewelry, furs, and other specified exclusions or limitations. However, these items can be covered by adding a floater (naming each article individually) or by supplementing your current policy with a specified valuables policy. To get help in adding your valuables to your policy or to apply for a specified valuables policy with one of our many companies please contact a friendly agent for assistance. -Additional Living Expense Most home insurance policies provide coverage for extra costs you might incur if your home is damaged by a loss covered in your policy so that your household can maintain its normal standard of living. The provision is only applicable if you cannot live there while repairs are made or if you are denied access to your home by a government order. The coverage is most likely subject to duration limits or any other stipulations in your policy. In some instances, this coverage includes the cost of eating in a restaurant, living in a hotel or storing some property. -Personal Liability Personal liability coverage is protection for you and all family members who live with you against a claim or lawsuit resulting from (non-auto and non-business) bodily injury or property damage to others (non residents) and for which are determined to have a legal obligation to pay. Defense costs are included, but this is usually only to the limits of liability specified in the policy. Once the specified amount has been used the insurance company will no longer cover any expense or costs. A personal umbrella liability (excess liability) will provide an extra level of liability protection. For information as to how you can better protect yourself contact one of our experienced agents for additional information. -Medical Payments This coverage pays the reasonable expenses for others accidentally injured on your premises or the areas immediately adjoining your property regardless of fault. This coverage DOES NOT apply to your own injuries or those of family members living with you, your intentional acts, rental use of your premises, or injuries that occur while performing a business you operate out of your home,

What is the difference between actual cash value and replacement cost?

Actual cash value refers to the amount, at the time the loss occurred, needed to repair or replace the property that was destroyed; this cost is reduced by depreciation. Replacement cost is the amount necessary to replace or rebuild your home with materials of similar kind and quality without reducing for depreciation. While most insurance policies cover the contents of your home at actual cash value it is possible to purchase replacement cost coverage for 10-15% more premium.

How can I get a lower premium?

There are a few things that you can do to lower you premium. The first and most obvious is to increase your deductible. This does two things: lowers your premium and reduces the temptation to make small claims, which will make a big difference when renewing your policy. Another is to make sure and shop around as much as necessary to guarantee you are getting a fair price. The biggest mistake that someone can make is to cut costs by reducing your limits of coverage. If you are under protected you will pay far more if you have a loss. Think about it this way if the difference in premium is $75 a year and you have to pay $25,000 to make up for being under insured was it really worth it? If you feel you are paying too much, please let one of our friendly agents work with you to get the protection you need at the price you deserve.

Do all homeowner policies cover flood damage?

Most homeowner policies do not offer protection against flood damage. Usually you can find your policy exclusions under “Section I – Exclusions” in your policy. Most likely it will be found under “water damage”. You can also find other exclusions in sections that are important for you to be aware of. If you are interested in flood insurance, or have questions about any other exclusion in your policy one of our friendly, and experienced agents will be glad to assist you.

What is excluded from most homeowner policies?

This is an important and difficult question to answer since each insurance company might exclude or include certain coverages. That being said, there are something that most exclude. The first exclusion would be coverage for pets (dogs, birds, fish, etc), automobiles and business property. If you run a business out of your home your business property and liability is not covered under the homeowner policy. The policy also excludes any loss or damage caused by flood, surface water, water which backs up through sewers or drains, earth movement, nuclear damage, acts of war, etc. In section II (personal liability and medical payments), you are not covered for operation, ownership, or use, of any aircraft, automobile, recreational motor vehicle, water craft powered by more than 50 horsepower motor; bodily injury or physical damage caused by an intentional act of the insured. This gives only a basic understanding of what is specifically excluded in a basic policy. It is important to make sure you understand what is and is not covered in your policy. While there are certain similarities in homeowners insurance there are differences that can cost you a lot of money in the event of a loss. Also, while some things may not be excluded they might have specific limits of coverage. Some examples of these are money, jewelry, furs, and or guns.

Do I need to keep an inventory of personal property?

Yes. It is important to keep records of things with a written list and pictures of the items. The insurance company is only obligated to pay for personal property that you can show you owned at the time of loss. By keeping your inventoried items you reduce stress and the potential that you will not be fully compensated for your personal property. Remember to always keep the documentation in a safe and fire-proof place.

What are they reasons to buy renter’s insurance?

There are many reasons to purchase renters insurance. Much like homeowner’s insurance, renters have a great possibility of loss. Since a renter doesn’t own the building, the cost of renters insurance is very inexpensive. While the greatest possibility of loss is the renter’s personal property, renters can also be liable to third parties that are injured while at the residence.

What is a personal “umbrella” insurance policy?

A personal umbrella (excess liability) is an important tool to protect you and your assets. This coverage provides liability coverage that is over-and-above the coverage provided under your homeowner’s, renter’s or automobile insurance. This is your “back up parachute” if you have a major liability claim. If you were involved in a big lawsuit this would pay after your primary liability (home and auto liability) has been exhausted. While it can be added to some policies as a rider it is most commonly purchased as a stand-alone policy. Most insurance companies require that you increase your liability limits on your existing homeowners, renters, or auto policy before you can accept this coverage. This is a very common coverage and while inexpensive can protect your personal financial security. For additional questions about umbrella policies please allow one of our friendly agents to assist you in finding the most suitable product for you.

What are the different “riders” I can add to a policy?

Many times a standard home owner’s policy is too basic to really fit your specific needs. The way that you can supplement your current coverages to protect you in vulnerable areas is to add a “rider”. This is an additional set of terms and conditions that “rides on” the basic policy. Here are just a few of the most common riders that can be added to your policy. -Scheduled personal property endorsement (personal property floater) Many insurance policies limit the coverage that is provided for specified personal property. If you have coin collections, cameras, large amounts of cash or securities, furs, guns and jewelry in excess of the stated amount of coverage, you can add a rider to the insurance policy which will protect you in the chance of a loss. The cost is usually determined on a “per thousand” dollar basis. The cost of this rider is often small when compared with the risk of loss. If you own items that are expensive and are unsure if they are covered it is always best to consult with one of our friendly agents to make sure. If it is not covered many times it is required to get an appraisal and simply add a rider to the current policy. -Special computer insurance Most equipment that is used in your home office will be excluded from a basic homeowner’s policy. This might include a scanner, fax, speakers, etc. While a rider will be a necessary step in getting you property insured it will be important to make sure you add a home business rider as well. -Income property This is a rider that is occasionally offered which covers residential premises other than your primary residence. This is most applicable if you own your home and an additional residence that you rent out. This rider would protect your additional residence by simply adding it to your current policy instead of purchasing a stand-alone policy. Insurance companies may vary slightly in the endorsements they offer. It is important if you have questions to ask one of our agents for help to ensure that you are always fully protected. -Secondary residence premises endorsement While this is similar to income property the main difference is that this endorsement applies to a secondary residence used as a vacation home. By purchasing a rider you are often able to receive the necessary additional coverage at a reduced rate as opposed to a separate, stand-alone insurance policy). -Theft coverage protection endorsement This endorsement increases the amount of insurance coverage for theft of personal property. Many insurance policies put restrictions on limits of coverage due to a theft loss, and this endorsement will help keep you protected if you feel that the specified limits are too small. As with adding any rider or endorsement you should always check the insurance policy to determine the amount and type of coverage it has for loss of personal property due to theft. -Home business More and more companies are allowing their employees to operate their business at home. A home-based business presents a variety of exposures to loss and having the proper coverage is very important. Most homeowner’s and renter’s insurance policies specifically exclude coverage for any loss resulting out of operation of a business (this includes both property losses and business liability. For example, a customer is burnt by coffee while meeting with you). This rider is an important way to protect yourself if your home-based business is excluded from you policy. -Watercraft and recreational vehicle endorsement A majority of homeowners, renters and auto insurance policies specifically exclude coverage for any watercraft or recreational vehicle, which is located (stored) at your residence. While adding this endorsement can be a great benefit and save you money on your premium, the situation might warrant a stand-alone boat insurance policy. The important thing is that you are covered properly and if you have any questions our friendly, experienced agents are standing by to help you. -Building Code Endorsement This endorsement covers the cost of bringing the dwelling up to code if the building codes have changed. Not all policies offer this and usually you can better protect yourself by ensuring your home at replacement cost rather than actual cash value. -Sewer and drains back-up endorsement Similar to flood (excluded on all homeowner’s or renter’s insurrance policies), this endorsement protects you from any damage that results from a backed-up sewer or drain. Many insurance companies offer a rider to protect against the risk, since it is commonly excluded on a basic homeowners policy.

How much is my home worth?

Before buying home insurance, you’ll have a choice: insuring property for “actual cash value” or for “replacement cost”. Both offer the same kind of liability, but they differ in the amount and type of property protection coverage. This difference often results in very different dollar amounts in the event of a loss. Actual cash value: “Actual cash value” refers to how the value of the property is determined in the event of a loss. Actual cash value takes into account depreciation – meaning that an item purchased new is worth less after having been “in-service” for a number of years. For example, you bought a sofa three years ago for $2,000. Fire destroys the sofa and you put in a claim with the insurance company. The insurer determines that the actual cash value of a sofa that is three years old is currently $500, and that is what they would pay you. If your policy has a $1,000 deductible, you’ll collect nothing. Replacement cost: “Replacement cost” likewise refers to how the value of the property is determined in the event of the loss. But the fundamental difference is that the value is set at how much it will cost you today to go out and buy a new item to replace the one that has been lost. In the example above, that $2,000 sofa may cost $3,000 if it were bought new today. With replacement cost coverage, when that sofa is destroyed today, after you have paid your deductible, the insurer pays you $3,000 to go out and buy that same new sofa replace the one which has been destroyed. Replacement cost policies are more expensive than actual cash value policies.

How much insurance do I need?

Determining what is the “right amount” for you is important to the long term protection of your family and assets. The minimum (minimums are usually a very bad thing to shoot for in insurance) is to insure your home for at least 80% of the home’s value. It is always beneficial, however, to insure 100% of the value and offset the increase in cost by raising your deductible amount. For example, instead of insuring a $200,000 home for $150,000 worth of dwelling unit coverage with a $200 deductible, consider insuring the home for $200,000 with a $2500 deductible. In the event of a loss you are going to be better off paying the $2500 as opposed to the $50,000 out-of-pocket.

How do I know if my personal property is covered at the right amount?

One way to ensure that your personal property is covered at the right amount is to make a list of the things you own, as well as, taking pictures. Remember to update this information as needed to ensure that you are up to date on your information at the time of the loss and not 10 yrs prior. One way to make this process easier is by taking each room section by section. With the use of the Internet you can search for the items in each section and add the information to your inventory. Also, remember to keep these records in a safe, fire proof place. If you have items of exceptionally high value (ex. Wedding rings, art work, antique collections), it is very import to have certified appraisals done for them. Also, check your policy to see if there are specific limits of coverage for certain categories of personal property. If you find your high value items are not completely covered under the current policy it is wise to purchase a scheduled personal property endorsement (personal articles floater) to your policy. The best way to protect yourself is to be proactive in keeping records so when it comes time for the insurance company to pay, you are not stuck litigating for anything.

Is it important to shop around? I thought all insurance policies were pretty much the same.

While many insurance companies have similarities in their standard policies, not all insurance companies are exactly the same. Much like anything you buy sometimes you can purchase a “product” that is not what you need. Also, making sure that you have the necessary endorsements can potentially save your thousands in the event of a loss. The bottom line — not all insurance policies are created equal. The differences usually result from how the insurance company “packages” its policy. Of course another reason is by comparing other policies you can make sure you are paying the best price for the best product. At, we are a brokerage working for you. We ALWAYS represent the customer and not the insurance company. Let us help you in shopping the top companies around to get the best price. We are committed to giving you great customer support paired with the ease of online shopping. So when you are ready, hit the “GET QUOTES” tab at the top of the page and find out how weare taking the hassle out of shopping for insurance and saving people money everyday.

What are the types of standard packaged insurance policies? What does it mean when it says Basic Form (HO-1) or Broad Form (HO-2)? What is the difference?

Here is a list of the common standard insurance policies, often referred to as “forms”. It is important to note that only the HO-3, HO-4, and HO-6 are covered at all-risk. These policies provide you with the most comprehensive protection. Basic Form (HO-1) This is the most basic (as the name implies) type of packaged insurance policy. This policy is designed for a homeowner who insures the home, detached structures, and personal property against losses caused by the following basic perils. Payment is only granted resulting from a loss of one of these specifically named perils. If it is a result of any other peril it will not be covered. fire or lightning windstorm or hail explosion riot or civil commotion aircraft vehicles smoke vandalism or malicious mischief theft damage by glass or safety glazing material that is part of the building volcanic eruption Broad Form (HO-2) This package insures the home, detached structures, and personal property against the same perils as the basic form (HO-1) plus the following. Again, as with the basic form, payment is only granted resulting from a loss of one of these specifically named perils. If it is a result of any other peril it will not be covered. falling objects weight of ice, snow or sleet accidental discharge or overflow of water or steam from within a plumbing, heating, air-conditioning or automatic fire-protective sprinkler system, or from within a household appliance sudden and accidental tearing apart, cracking, burning, or bulging of a steam or hot water heating system, an air-conditioning system, or automatic fire- protective sprinkler system freezing of a plumbing, heating, air-conditioning, or automatic fire-protective sprinkler system, or of a household appliance sudden and accidental damage from artificially generated electrical current (does not include loss to a tube, transistor, or similar electronic component) Special Form (HO-3) The special form (HO-3) policy is the most commonly purchased type of homeowners policy because it offers a broad range of coverages on a named peril basis for personal property and “all risk” coverage for the dwelling and other structures, except those specifically excluded, such as war, flood, or nuclear accident. Always consult the exclusions portion of your home policy to know what is not covered. Modified Coverage Form (HO-8) This package provides coverage for the personal property and dwelling that is similar to the basic form (HO-1) policy, but is designed specifically for older homes that do not meet some or all of the underwriting standards applicable to other forms of home policies. This policy usually always excludes the option for replacement cost coverage. Renters’ or Tenants Policy (HO-4) This package will insure the household contents and personal belongings, but not the building, of renters against the same perils detailed in the Broad HO-2 form. Condominium Owners Policy (HO-6) This form is similar to the Renters’ or Tenants policy (HO-4) which provides broad form (HO-2) coverages and no coverage for the condominium structure itself. This is most commonly covered under a Special Condominium policy available only through a condominium association. It also normally provides personal liability protection. Mobile Homeowner’s Policy (HO-2 or HO-3) A mobile homeowners policy carries with it certain specifications due to the special characteristics of mobile homes. A special form, which pulls from the broad form (HO-2) and the special form (HO-3) are packaged with the mobile homeowner specifically in mind. These are not as standardized as the homeowner’s policies. Farm or Ranch Policies A commercial package of coverage’s which are specific to farm and ranches.

How do I know if I am using a good insurance company?

There are a few ways that you can find an unbiased rating on every insurance company. The three main sites are: A. M. Best Company, Moody’s Investor Service, and Standard & Poor. These sites provide financial information and ratings for insurance companies. The most readily accessible rating company is A.M Best. You visit online, or find the A. M. Best book in most libraries. Make sure you understand the method or scale they use to evaluate the insurance companies. Also, it is important that you look for updated sheets or call the rating company to be sure.

Am I allowed to cancel my policy at any time?

Yes, since you are the policy owner, you are able to cancel your insurance at any time. You will receive a refund of the unused insurance premium, but it will be at the “short rate.” This means that your refund will have the expenses the insurance company incurred in establishing coverage deducted from the total of unused premium. Always make sure you get approved for coverage BEFORE you cancel with your existing company.

Do I really need life insurance?

Do I really need life insurance?
Yes, in most situations there are several reasons why you may need life insurance. The most important reason is to have enough money to provide for the people that rely on your income, such as young children, non-working spouses or elderly parents. Also, your loved ones may need funds to pay for extra expenses that may arise due to your death, such as funeral expenses, or other expenses to pay off bills and debts. If you have no dependents or have saved enough resources to protect your loved ones, you may not have an actual need to purchase life insurance. However, some people who do not “need” life insurance still purchase it anyway. These individuals use the money to leave to a beneficiary or beneficiaries to create an estate or help in minimizing tax implications caused when willing a large estate. If this last category applies to you it is advisable to consult with professionals or specialists in insurance-related law, accounting or estate planning because legal business agreements or trust documents may need to be drawn-up.

Why should I buy life insurance?

Why should I buy life insurance?
Some reasons to buy life insurance are:

I have group insurance from work or social security or mutual fund assets. Won’t these cover these needs?

I have group insurance from work or social security or mutual fund assets. Won’t these cover these needs?
Usually not. Many times your needs are greater than the available funds. To determine if your other “insurance” would be adequate, contact one of our friendly agents to send you a needs analysis worksheet.

What does it mean to be the owner of a life insurance policy? Who is the owner of my policy?

What does it mean to be the owner of a life insurance policy? Who is the owner of my policy?
Most of the time this insured is the owner of the policy, unless it has been specifically set up to name a different owner. The owner is the person who is authorized to change the beneficiary and make other changes to the policy.

Will I have to be examined by a doctor to buy life insurance?

Will I have to be examined by a doctor to buy life insurance?
This will vary from company to company and for different types and amounts of insurance. For small amounts of insurance or for group plans, no exam usually would be needed, but company underwriters need to examine and collect medical information on most new customers in order to properly classify the level of risk and set the appropriate premium charge. This will be assessed according to the answers to questions about the applicant, and may determine whether a physical examination is required. If an exam is needed, the insurance company should arrange a convenient time and place for you to meet the doctor or paramedic at NO charge to you. Usually, the exam will involve only basic medical tests and medical history unless large amounts of insurance are applied for.

Should I name a person(s) as the beneficiary of my life insurance or make my estate the recipient and have it distributed according to my will? Does the beneficiary have to be one of my relatives?

Should I name a person(s) as the beneficiary of my life insurance or make my estate the recipient and have it distributed according to my will? Does the beneficiary have to be one of my relatives?
The beneficiary (or beneficiaries) must have an insurable interest in the insured. Frequently this would be a dependent, such as a spouse or children, who would suffer a loss if the insured were to die. Many times it is better to name a person or persons as your beneficiary unless you have a specific reason to designate the estate as your beneficiary. Your beneficiary or beneficiaries do not have to be related to you.

If I am living with someone but we are not married, can I buy insurance on that person or have my partner as my beneficiary?

If I am living with someone but we are not married, can I buy insurance on that person or have my partner as my beneficiary?
The person named as beneficiary has to have an “insurable interest” in the life of the insured. A relative or a business partner would usually qualify, but designating other people who are not relatives may require you to offer an explanation or reason why this insurance is needed. Once a policy has been issued and is in force, you can change the name of the beneficiary who has an insurable interest.

What is the importance of health, age, and sex?

Health is often the most important factor, followed by age and sex. Someone in poor health will have to pay a very high premium, or even be uninsurable. Increasing age raises the cost of life insurance, because the older you get, the greater your chances of dying. Also, sex can be a factor, males costs more, because females live longer on average.

How does smoking affect my ability to buy life insurance?

If you are a smoker, you should expect to pay a little more for your life insurance.

I am healthy but like to participate in some potentially risky activities such as skydiving, or race car driving. How will this affect my ability to buy life insurance?

The insurance company will likely want some details about these activities and how frequently you engage in them. This may or may not result in a higher premium. In some extreme cases it may increase your difficulty in getting insurance. If you are unsure if something is risky, please give our friendly agents a call.

Should I be concerned about the company’s financial strength?

Yes. There have been a few failures by life insurance companies in recent years. The percentage of companies that have failed is very small and most of the customers have eventually received what they were entitled to. Our brokerage works very hard to always provide you with companies who are financially sound.

I was treated for cancer 10 years ago but my doctor said that I was completely cured. Will I be turned down for life insurance?

This will depend on the insurance company. Every insurance company has different standards for underwriting. While one company might approve you at the standard rate, another might charge a higher than standard rate. Another might turn you down. Also, there are some companies that promise guaranteed issue of an insurance policy despite your health problems. These companies usually limit the amount of insurance to a few thousand dollars and their rates tend to be high. Also, the policy may be limited to a refund of premiums and interest if death occurs during an initial period of several years. But after the initial period, the policy will be in full force. Fortunately, since we offer many different companies in this business, you have a good possibility of finding one that will cover you. Our job is to work for you and make sure you get the coverage you need.

Is it a good idea to cancel my life insurance policy and purchase a new one?

It depends on your specific situation. It may be beneficial to cancel a term policy purchased several years ago if you can get one that better meets your needs and costs less. Term insurance rates are always very competitive and you may be able to get more for less today, even allowing for your greater age. That being said, be careful to that the new policy is issued before canceling the existing policy. Changes in your health status or more rigorous underwriting for a new policy could prevent you from getting the new one, or increase the price significantly. If you are considering replacing a cash value policy, you should consider the new and old policies in great detail. It is often not to your advantage to replace a cash value policy because cash values tend to build up slowly and you would be starting that buildup again with a new policy.

What if I miss a premium payment– will I lose my insurance?

The grace period to pay your premium is typically 30 days. After that, the company may or may not allow you to pay back premiums and reinstate the policy. Sometimes this may depend on whether you can provide evidence of good health. But if you are beyond the due date and grace period, you are at the insurance company’s discretion. If you die and the premium has not been paid, and there is no residual value to pay premiums in the policy, the beneficiary would not receive the premium.

I forgot to pay my premium and the policy lapsed. Is there anything I can do?

Many times the answer is yes. Some insurance companies require only that you pay the back and currently due premiums and certify that you are still in good health. This could involve answering questions and possibly undergoing another medical examination.

Is it true that insurance doesn’t pay on a suicide?

Suicide is not covered during an initial period, which is often two years. After that initial period, which is specified in the policy’s suicide clause, suicide is treated the same as any other death.

Are there tax benefits associated with life insurance?

Yes, There are two important tax advantages associated with life insurance. The first advantage is that death benefits are generally not taxable as income for income tax purposes when a person receives insurance pay out. The second tax advantage is for cash value plans, there is generally no tax on the increase in the cash value as it grows over the policy period.

How do life insurance settlement options work?

Insurance companies offer customers numerous options for settlement. Most life insurance policies offer a single lump sum payment. Another option is for the recipient to receive a monthly payment for the rest of their life. This option would also work if the beneficiaries were more than one person.

How much life insurance do I need?

This amount of insurance you might need is based on a number of different factors. For example, If you are providing financial support for people who are depending on you it is important to determine how much your family would need to replace your lost income and for how long. There are other factors that will help in determining the right amount. Paying for college education, remainder of a home mortgage, paying off debt, are just a few of these. The best thing to do is to complete a needs analysis with one of our friendly agents to make sure you are properly insured.

What’s the difference between term, whole life, and convertible term insurance?

The easiest way to think about life insurance is that there are two basic types: Whole life and Term life. Whole life insurance, the most traditional form of “permanent” insurance, can be kept in force for as long as you live. The face amount and the premium are fixed at the time you buy your policy and stay the same even as you age. The policy’s cash value grows at a rate of return specified in the policy and can be used as collateral to take out a loan, or used to pay up the policy (this is called reduced paid up). While permanent insurance is usually recommended as the core of an insurance strategy, term insurance is good for people who need coverage for short periods of time or to pay off a specific debt (i.e. home mortgage.) While term policies have lower premiums initially, they will increase after the specified policy period (10 yr, 20 yr, etc) if the policy holders choose to renew their policies . Benefits are paid only if death occurs during the period covered. If you stop paying premiums, the insurance stops. “Convertible” term is a provision on a term life policy and can be used to exchange the term policy for permanent insurance without a medical examination. This usually costs a little extra and the permanent policy will have a higher premium. Term policies generally have no cash value. Each type of insurance has its own advantages and limitations, and many individuals find that a combination of two types is the right choice. If you have more questions about this subject please feel free to call and have a friendly agent advise you based on your individual needs.

How does an accelerated death benefit work?

Many insurance companies now offer this “living benefits” option to ease the financial burdens of the seriously ill or incapacitated. It allows the owner of the policy to receive all or part of the policy’s proceeds prior to death under certain circumstances. Because payments may affect tax status and Medicare eligibility, and will be deducted from the overall benefits paid later to beneficiaries, policy holders should thoroughly investigate using this benefit in advance.

Why do I need a medical exam to get insurance?

Medical tests help to provide current information about an applicant’s health, which enables insurers to charge premiums that reflect the appropriate levels of risk. Some health conditions are easily managed through proper medication, therapy or lifestyle changes, so a medical test makes it possible to diagnose these illnesses. In extreme situations, serious or incurable conditions present an enormous risk and coverage will not be offered.

How do I choose a life insurance beneficiary?

There are a couple things to consider when choosing a beneficiary. Many times it is best to select a specific beneficiary, rather than having the proceeds of your life insurance paid to your estate. First, the greatest benefit of life insurance is that it can be paid to your family immediately. If it is payable to your estate, however, it will have to go through probate with the rest of your assets.
 Secondly, always be very specific in wording beneficiary designations. For example, saying “wife of the insured” could result in an ex-spouse getting the proceeds. Naming specific children may exclude those born later. If your child dies before you, do you want the proceeds to go to that child’s children? Changing the beneficiary designation is easy, but you have to remember to do it. Lastly, always name a “contingent,” or secondary, beneficiary, just in case you outlive your first beneficiary. Due to the complexity of some applicant’s individual situations it is recommended that you call one of our friendly agents to help you properly set up your beneficiary designation.

As a single person, do I need insurance?

The answer almost definitely is yes. Insurance is designed to help protect not only your family, but also your lifestyle. In most situations, people haven’t looked at how they might be vulnerable in certain areas. While these types of insurance are inexpensive, they can end up saving you many thousands, even millions of dollars. Our friendly agents are here to give you information about your options, and remember as brokers we are working for You, not the insurance companies. Here are some insurance options you may want to consider:

What happens if I miss my required premium payments?

If you miss a premium payment, you typically have a 30- or 31-day grace period during which you can pay the premium with no interest charged. After that, the company with your authorization can draw from a permanent policy’s cash value to keep that policy in force. It is important to note that this is only for whole life policies, which accrue cash value. This will not protect you if you have a term policy. In most cases it is beneficial to set up automated payments to keep losing coverage due to non-payment.

What if I can’t pay the premiums because I am disabled?

There are provisions or “riders” that can be added to a policy to provide an additional assistance. One such rider is a waiver of premium for disability. With this rider, if you become totally disabled for a specified period of time, you don’t have to pay premiums for the duration of the disability.

When does the policy start?

The date that insurance begins depends on two things: the inception date specified by the applicant, and the day that payment is offered by the applicant to the insurance company. The effective date can be different from the date the company issues the policy, if you want it to begin on a later date, When you decide to purchase the policy, always check when the insurance becomes effective.

Will my plan cover the services and care that my family will need?

This should be a prime consideration and a major motivation in choosing one plan over another. Many times, each plan will differ with what the definitions of preventative, basic, restorative and major services are. That’s where our experienced agents could help you by explaining what each plan offers. At, we shop the top providers and get you the protection your family needs at the price you deserve. Remember, we work for you and not for the insurance companies.

My dentist recommends a treatment that my plan will not pay for. Does this mean the treatment really isn’t necessary?

It is common for dental plans to exclude treatment that is covered under the company’s medical plan. Some plans, however, go on to exclude or discourage necessary dental treatment such as sealants, pre-existing conditions, adult orthodontics, specialist referrals and other dental needs. Some also exclude treatment for family members. Patients need to be aware of the exclusions and limitations in their dental plan but should not let those factors determine their treatment decisions.

My dental plan says that it will pay 100% for two dental checkups and cleanings each year. Does that mean that for preventative procedures, I never owe any extra beyond our monthly premiums to the insurance company?

In most cases, yes, you will be able to walk in and walk out with out having to owe any money out of pocket. But, plans that describe benefits in terms of percentages, for example, 100% preventive care and 80% for basic care are generally Usual, Customary and Reasonable (UCR) plans. The administrators of UCR plans set what the plan considers to be a “customary fee” for each dental procedure. If your dentist’s fee exceeds this customary fee, your benefit will be based on a percentage of the customary fee instead of your dentist’s fee. Exceeding the plan’s customary fee, however, does not mean your dentist has overcharged for the procedure. These plans pay a set percentage of the dentist’s fee or the plan administrator’s “reasonable” or “customary” fee limit, whichever is less.

Who is covered by my dental benefit plan and what exactly is covered?

This information is all going to be answered in the policy conditions. Call one of our friendly agents who can help you answer questions specifically on your policy. We offer unbiased advice, because we work for you, not the insurance company.

My dentist is not on the list of dentists provided by my plan. Can I still go to them for treatment?

You may always go to the dentist of your choice, but the dilemma is whether or not you will have the best benefit coverage for the treatment you receive if it is provided by a dentist who is not on the plan’s list. Under certain contracts, such as a PPO (Preferred Provider Organization) program, patients are given a financial incentive to go to certain dentists but do receive some level of dental benefit, regardless of the treating dentist. Other plans, such as capitation programs, do not provide any benefit coverage for treatment given by “non-participating” dentists.

What is the difference between a PPO and a capitation program, in regard to a dentist?

Preferred Provider Organization (PPO) programs are plans under which the insurance companies have contracting dentists that agree to discount their fees for patients who choose to use them. If the patient’s dentist of choice does not participate in the PPO plan, the patient will have a reduction or complete loss of benefits with that dentist. Always call and ask your dentist if they accept your dental insurance provider before you have any services done.
A capitation program pays contracted dentists a (most often) monthly fixed amount per family or patient. In return, the dentists agree to offer treatment to the patients at no cost; although sometimes co-payments would apply, depending on the severity of the treatment.

My spouse and I each have a dental benefit plan through our work. Who in our family is covered by these plans?

Your program is going to cover you and your spouse’s program is going to cover him/her. In addition, you may have additional coverage from each other’s programs if they cover spouses and dependents. But, the insurance companies will not “double cover” you so that you may make money off of being insured on both policies.
First and foremost, your plan is going to stipulate whether dependents are covered on it or not. Then, the primary plan for covering your children depends on the regulations in your state. Most plans use the “birthday rule” (spouse with birthday occurring earlier in the calendar year is primary). Others consider the father’s plan primary. The American Dental Association has recognized the “birthday rule” as the preferred method for coordinating benefits, but which rule applies to your family depends on the language in your dental plan definitions.

My policy offers Direct Reimbursement, what is this?

Direct Reimbursement refunds patients a percentage of the dollar amount spent on dental services and care, regardless of treatment category. Generally speaking, this method does not exclude coverage based on the type of treatment needed and will allow the patients to go to the dentist of their choice.

What fixed factors make up the price of my group or individual health policy?

There are factors that can’t be changed when looking at lowering health insurance premiums. For the most part, Group health insurance plans do not use underwriting for individual plan participants. Once the Group is offered health insurance coverage, individuals who are members of the group automatically qualify for the insurance (often with open enrollment periods to switch coverage’s at a particular time, that which the employer chooses, during the year). Furthermore, Group plans are underwritten using the same criteria as Individual health insurance plans (age, health history, number of people covered, occupation, and lifestyle). With age, older people have a higher incidence of claims than younger people and require higher premiums for coverage.
Number of people covered matters whether coverage is offered solely to the individual or if coverage will also be extended to family members and dependents.
Health history is primarily used in underwriting individual insurance plans, a history of disease or illness will impact whether a particular insurance company will offer insurance, and if so whether pre-existing conditions or other restrictions will be placed on such insurance. Also, some occupations involve more risk of injury or illness due to the nature of the work and in turn require a higher premium. Lastly, their lifestyle matters in whether a person smokes or engages in a hazardous hobby which exposes the individual to a greater degree of risk or disease, illness, or potential for accident.

My insurance company rejected a claim. Is there anything I can do?

For starters, you can check your policy or employee booklet for the company’s appeal procedures. Then speak to a representative of the insurance company and ask why the insurance company had rejected the claim. If after speaking to the representative and you are still unsuccessful, contact your state’s insurance regulatory office for help. In most cases, a company will be more inclined to resolve a dispute after the state office is in your corner and acts on your behalf.

I will be vacationing outside the United State for several months. Will my medical insurance follow me anywhere I go?

This is a question that is policy specific. If you can look into your policy, or you can contact us and we could look into your policy, to see what coverage your plan offers. Another idea is that you might also want to consider picking up a short-term medical evacuation policy or even better, Travel insurance. This will pay costs like your return to the US in case of a medical emergency, or even emergency cash transfer. You can get a quote for this on or call one of our friendly agents.

I am brand new at looking into individual health insurance, is it possible to find coverage that fits my individual or families needs and at the same time won’t make me broke?

Of course it is. That is what we specialize in. One option to ensure an affordable premium on any budget would be to consider a high deductible insurance plan. The benefit is that your premium would be a great deal less because you are fronting some of the risk by paying more out of pocket for any medical expenses. With the high deductible insurance plan or any insurance plan, a Health Savings Account (HSA) will allow you to pay the medical expenses occurred with tax deferred income. While HSA’s have some restrictions and guideline that you must follow, they are a great way to help offset the costs of high medical bills. For other cost saving tips on how to reduce your health care premium, please refer to “What will affect my insurance premiums.” Once you have made up your mind on what type of plans that you need, either click on the GET QUOTES tab at the top or contact us, and we can get you set up in a plan this built just for you. Remember we shop the top insurance providers and get you the protection you need at the price you deserve. At, we work for you, not the insurance companies.

I have just graduated from college and am not sure about what insurance products that I need, where could I find some help?

Graduating college and really getting your life started can be a stressful venture.
It is the perfect time to set yourself up with a good insurance base and the start of that financial base would be quality insurance products.
For starters, your parents will probably drop you from their insurance policy and it will be time to shop around for the best car insurance. Next and probably most important, is if your job does not offer health and dental insurance, it is important to get an insurance plan started as soon as possible. If you were to not have health or dental insurance, and you had a medical/dental emergency, it could put you in major debt quickly. Furthermore, since you are going to be investing in a home or nice items to fill your apartment, it is important to know the need for a good home owners/renters insurance policy. Just think how devastating it would be to lose your home and the belongings that you have worked hard for. Also if you have any friends over, it has a liability policy built into it, which is to protect you in case some one had an accident while on your property (generally speaking).
Also, when you get to the point that you have a significant other or dependents that would be left asking, “how am I supposed to pay for this?”, if you were to pass away, then you would definitely need life insurance.
Feel free to contact us, and we can walk you through which plan best fits your needs. Remember we shop the top insurance providers and get you the protection you need at the price you deserve. At, we work for you, not the insurance companies.

Will I have coverage for substance abuse and mental illness?

Major medical expense plans generally provide coverage for treatment of substance abuse (alcoholism and drug usage) and mental illness. A higher coinsurance percentage (for example 50%) and a lower lifetime benefit limit (for example $20,000 or $50,000) generally applies also. In addition, the extent of how much coverage you have may depend on whether treatment is provided on an in-patient or out-patient basis.

What’s the difference between primary and secondary coverages?

When a person is covered by more than one health insurance plan the insurance companies have a provision for payment of claims to prevent double coverage to pay double to the insured. Most often the primary coverage is determined by whose plan the insured is a member of. If a spouse is employed by a company, the insurance associated with that company would act as primary. Another method might be using length of time associated with a certain plan. Who ever the insured has been with the longest would serve as primary. Secondary coverage usually comes in if the insured is covered as a dependent under someone else’s health insurance plan. This coverage would usually provide reimbursement after the primary coverage has been exhausted.

What does my health insurance pay for?

A health insurance policy generally pays for medical expenses, which result from an accident, injury, or illness. Each policy differs slightly on how claims are paid, and what the requirements are to receive payment. The deductible, co-pay, and waiting periods are all subject to the specifications within the individual policy. Typically a health policy will also cover visits to a doctor, non elective surgeries and surgery expenses, costs of hospitalization, and follow-up therapy or rehabilitation. Some plans will also provide mental health coverage, including drug/alcohol rehab, psychiatric care, counseling, etc. Again, each plans features and benefits will vary according to the different policies and insurance companies. Make sure you read and understand your plan features before you purchase a policy.

What is the difference between co-insurance and co-payment?

While these terms are often used interchangeably, there are some very significant differences between coinsurance and co-payment. Coinsurance, which is sometimes referred to as “percentage participation,” requires that the insured contribute to the cost of medical care. Under the common 80/20 co-insurance provision, the medical expense plan pays 80 percent of eligible medical charges after the deductible has been met, and the insured is required to pay the remaining 20 percent. To protect from the insured suffering a severe financial burden, in the event of large medical catastrophe (ex, car accident, cancer, etc), most insurance companies offer a stop loss limit. While often referred to as an out of pocket max or co-insurance cap, this provision will place a limit on the max out-of-pocket per year. The size of the coinsurance cap typically varies and usually ranges from $2,000 to $10,000, depending on the plan. After the cap has been met, all qualified expenses above this amount are paid in full. Under a co-payment or co-pay provision, the insured is typically required to pay a fixed dollar amount (e.g., $10, $20, or $30) each time a specified medical service is completed. A co-pay amount of $50 might be charged for a doctor’s office visit or $25 to fill a prescription. Co-pay provisions are frequently found in medical plans offered by health maintenance organizations (HMOs) a co-pay provision will pay 100% of these expense up to the plan’s specified maximum limit of coverage. Under this provision, no co-insurance is required because the contribution by the insured is paid on a fixed amount. It is important to not that there is no cap or stop loss limit with co-payment.

What will affect my insurance premium?

There are a number of factors that will affect a health insurance premium. Many of these can be changed or modified to get a price that is reasonable. These are simply a few of the factors that are calculated in the monthly premium. If you have more questions about ways that you can increase or decrease coverage, please don’t hesitate to contact one of our friendly agents to assist you in determining the plan that is best for you.

  • Deductibles
    The fixed amount you have to pay out-of-pocket before your insurance begins the reimbursement of your expenses. The higher the deductible is, the lower the premium.
  • Co-payments and co-insurance
    These are usually assessed after the deductible. These are the contributory portion of the insured for medical expenses rendered. Changing the limits or percentages can increase or reduce your premium amount. For more information regarding this subject please see “what is the difference between co insurance and co payment?”
  • Lifetime maximums
    This is the maximum amount of coverage that will be paid on your behalf during your entire lifetime. The higher the maximum limit, the more coverage is available, which results in a slightly higher premium.
  • Annual or “out-of-pocket” limits
    This is defined as the maximum amount of deductible and co-payments you have to pay each year. The lower this annual limit, the higher the monthly premium.
  • Renewability/Cancellation
    This is a provision that guarantees the ability to renew or that the only way an insurance company can cancel your medical coverage is if you don’t pay. Usually this will cost the insured an extra premium.
What are my insurance options if I am just between jobs? Do I have to get a full year policy?

Many of us find ourselves in a position where we are between jobs, but we know it is important to have health insurance coverage in the mean time. One option you have is to invest in a short-term health policy. These policies can be written for one month to 6 months policy periods. A short-term policy is a great stop gap option because it provides much of the same coverages you would receive with an annual policy, but for smaller periods of time. Also, setting up a short-term policy is just as easy as an annual policy. If you have questions or need assistance we are here for you. Please contact one of our friendly agents, and they will help walk you through the process.

I am confused by all the different types of health plans. What is the difference between an HMO and a PPO?

Understanding the differences between the different health plans will ensure that you make the right choices for your individual needs. The two main plan types are HMO, and PPO. An HMO (Health Maintenance Organization) is an organization that provides or simply arranges coverage of certain health care services to members of the organization. These coverages typically include access to a primary care physician, getting emergency care, hospitalization, and visits to specialists. Usually HMOs are structured from a preventative standpoint. They do this by attending to your health needs when you are healthy to prevent costly diseases or illnesses later. Much like anything there are advantages and limitations to using an HMO. The biggest concern that is associated with the type of policy it the lack of selection of primary care physicians. In some cases finding a nearby doctor that is accepted in your plan can be frustrating. Another criticism is that the HMO may deny certain claims and possibly make health care decisions based largely upon profitability, as opposed to decisions driven by providing the best level of care for its patients. While there are limitations, there are also some advantages. There are many HMO’ s that take very good care of their member’s health care needs while managing and implementing cost effective strategies which help to keep premium levels low. The next major plan type is called a PPO or a Preferred Provider Organization. This health care organization is probably the most prevalent type of managed care. Under this plan the health care providers (doctors) are contracted to provide medical services at a pre-negotiated rate. Members are encouraged to go to these doctors because they are “in network” or already contracted with the PPO’s plan. Members generally will pay increased out-of-pockets costs for services rendered when visting a doctor who is “out of network” with the PPO. These plans are typically better at accepting claims, but have higher premiums due to the fact that they are more likely to pay out for medical treatment.

I am worried about switching health insurance because I have a pre existing conditions?

Losing health coverage for a pre existing condition is arguably the greatest worry that many have is when switching health insurance provider (ex switching jobs). There is good news, however, and some pretty important laws that are in force to help insure that you are about to receive coverage. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) guarantees continued health insurance coverage for employees and their dependents. HIPAA imposes limitations for health insurance companies from excluding coverage of pre-existing conditions. This law also provides credit for prior health insurance coverage and a way in which an insured my provide certificates regarding such prior health coverage to a new group health plan. Discrimination in enrollment and/or the premiums paid by employees and their dependents based on health factors, and other protections for obtaining health insurance is prohibited by law. This law applies to employees, as well as, employers sponsoring a health plan. What this means for anyone that has a pre-existing condition is that when you have been covered by a group health insurance, individual, or any other medical plan for more than 12 months there will be no pre-existing conditions exclusion of new group health insurance when the employee enrolls as a participant in a new group health insurance plan. For example, you obtained treatment for a health condition 3 months ago, and were covered under an individual or group insurance plan for the past year, your new group health insurance plan is prohibited by law from excluding coverage for that condition.

Can the insurance company deny payment for my pregnancy because of the pre-existing condition clause?

For many people this is a very important question. There is reassuring news for women that are pregnant or think they may be pregnant, but don’t have insurance. According to HIPAA (Health Insurance Portability and Accountability Act of 1996), pregnancy cannot be considered a pre-existing condition. Furthermore, your new born child cannot be excluded from coverage, and you have 30 days to add him or her to your health insurance policy. While this is great news for people who are expecting a child, there are a couple issues to consider. Even though they cannot deny coverage for the actual pregnancy, any medical issues or complications that arise from a pregnancy, can be excluded. For example, if there is a major complication during or after pregnancy this can be considered a pre-existing condition and would be subject to a waiting period. The best thing to do to protect yourself is to shop around for health insurance now to make sure that you are properly protected prior to pregnancy.

What is a Health Savings Account (“HSA”)?

A Health Savings Account is an alternative to traditional health insurance, and works as a savings product (a government savings account) that enables you to pull pre-taxed money to pay for current health expenses and save for future qualified medical and retiree health expenses. These savings accounts are not for everyone, and have a few qualifications that must be met. First, you must be covered by a qualified High Deductible Health Plan (HDHP) to be able to take advantage of HSAs. For more information about HDHP’s please read “What is a High Deductible Health Plan?” The second consideration is that the money should be used only for medical expenses and cannot be used to borrow for other needs. There is also a limit to the amount that can be contributed per year. For 2009, these amounts increase to $3,000 for single HDHP coverage and $5,950 for family HDHP coverage. Finally, understand that you own and you control the money in your HSA, so it is important for you to decide what types of investments to make with the money in the account in order to make it grow.

What is a “High Deductible Health Plan” or HSA plan?

This type of plan is sometimes referred to as a “catastrophic” health plan. This plan is generally less expensive, and will most of the time exclude payment for the first several thousand dollars of health care expenses. This is due to the high deductible. After the deductible is met the plan will generally cover you barring any exemptions that lie within the policy. For obvious reasons this plan is used primarily as a way of protecting yourself from a major medical issue. Now it is important to note that your HSA is available to help you pay for the expenses your plan does not cover (i.e. Meeting your deductible). Some HDHPs can have co pays for preventative care. Again, while these plans can be very beneficial, they are not for everyone. If you have questions or concerns about whether a HDHP and HSA are right for you, please call one of our agents to assist you.

What is vision insurance, and what does it cover?

Vision insurance provides coverage for services rendered by eye care professionals such as ophthalmologists and optometrists. The typical vision insurance plan provides yearly coverage for eye examinations and partial compensation for eyeglasses, sunglasses, and contact lenses.

Do I need it?

Vision care experts agree that the No. 1 eye problem, nearsightedness, is caused by the stress related to close-up reading, such as is done with computers. (You just scooted your chair back, didn’t you?) An annual eye exam is a critical component to an overall wellness plan, as it can lead to the detection of serious diseases like high blood pressure and diabetes. Give us a call so that we may set you up with the vision plan that best fits your and your family’s needs.

What is disability insurance, and why is it important for me to have?

Disability insurance, an invaluable and often times over looked personal insurance product, is used to replace the lost income from work should you become disabled, and unable to work. The disability insurance policy will stipulate when you are eligible to begin receiving benefits, amount of the payments, the duration of coverage, and a description of exactly what constitutes being disabled. This, being paired with life insurance, is an excellent way to indemnify your family, were there to be a covered loss. Call us to let our experienced agents give you more information on why disability insurance is important for you.

What does disability insurance cover?

After an initial period called the “waiting” period, disability income insurance pays a specified percentage of your income while you are disabled. The payments continue for the duration of the disability or until the maximum time limit stipulated in the policy.

I now see the importance of disability insurance, what are the different plans?

Then you should look for a plan that provides coverage until retirement age or even for life. It should be non-cancelable (the insurance company cannot end your coverage) and guaranteed renewable (the rates are guaranteed not to increase). There are also inflation guards, or CPI’s which the benefit paid out will be raised due to the cost of living adjustments. We would be happy to walk you through which policy offers you the protection you need at the price you deserve.

Is there a disability policy that would cover the obligation to pay our mortgage?

There is a mortgage disability rider that you can purchase or if you become disabled and have private disability insurance, you can set up the benefits to be paid toward the mortgage, so that you and your family doesn’t lose the house. A mortgage is one of the largest financial obligations for most families so it would be a great relief to have the payments covered by disability protection.

Does my occupation affect my eligibility to receive disability insurance?

Yes. If your occupation places you at great risk of injury (skydive instructor, for example) or illness (someone who works around hazardous materials) you can expect to pay more, or sometimes be ineligible, for disability insurance. That being said, some occupations are relatively safe, but have a risk of a relatively minor illness or injury leading to a severe or even career threatening disability. For example, a minor injury to a finger could end the career of a concert violinist, or a slight unsteadiness of the hand or a back problem could prevent a neurosurgeon from continuing to operate on patients.
A key clause in a disability policy describes what occupations you may be able to perform. For example, a policy may specify that you are considered disabled when you cannot perform your normal occupation. Suppose you are a veterinarian and you become injured so that you can no longer work on animals. According to the above definition, you are disabled, and are entitled to receive disability payments. A policy with this occupational description offers strong protection for you. However, assuming you can find an insurance company willing to write such a policy, it will probably be more expensive – require higher premiums — than one of the other possible descriptions.

What is a partial disability and how is it covered?

You are totally disabled if you cannot perform any of the normal functions required by your occupation. If you can perform some, but not all of the functions of your job, you are partially disabled. Whether or not your disability policy covers partial disability depends on the details of the specific policy. If the policy covers partial disability, it will probably pay a portion of the full payment until you can resume all of your regular job duties.

I thought that the government would take care of me if I become disabled?

No. Although Social Security and certain other government plans do provide some disability protection, they were not intended to give you sufficient replacement income – only to provide a survival level of income. Social Security disability coverage usually begins after you have been disabled for six months, provided you meet Social Security’s rather tough requirements. About 70 percent of applicants fail to meet the requirements. If you qualify for benefits, the monthly payments are quite low.

What is the difference between private disability coverage and worker’s compensation?

With disability you buy the policy, select the benefit levels, and pay the premiums yourself. Also a worker’s compensation plan is based on you continuing to work with your current employer or in the state where you now live, whereas disability follows you. Furthermore, it is not limited to work-related disabilities where worker’s compensation is. Since private disability coverage is only for the person stipulated in the policy, we can find you the policy to fit specific needs.

I am having cosmetic surgery, and the doctor said that I will be unable to work for three weeks, would this be covered by disability insurance?

No, being off work to have cosmetic surgery would usually not qualify for disability insurance.

I was doing yard work when I suffered an accidental injury. Will I qualify for disability?

Yes. Since it was accidental, you would qualify.. If it was intentionally self-inflicted and not an accident, you would not qualify.

Does my disability policy cover rehabilitation services?

No, disability income policies provide income to replace the income lost because you are unable to work. That being said, once you receive disability payments, the money can be put toward whatever you choose. To specifically cover rehabilitation expenses, you would need to ask one of our friendly agents about medical and long term care insurance quotes for you.

What should I expect to pay for disability insurance?

Like all insurance products, premiums depend on many factors, including the individual’s personal history, your plan design, and the insurance company’s historical loss experience for consumers that match your personal history. Therefore, it is difficult and may be misleading to give a range of rates, when each situation is different. The best plan is to get several quotes from different insurance companies to see what the best rate is that you can pay to cover your insurance needs and meet your personal needs. Luckily, we have the top companies and will find the best product to fit your individual needs.

Do I have to be confined to a hospital to in order for me to receive my disability benefits?

No, for most medical conditions, the majority of patients are in the hospital for only a small part of their period of disability (in some cases as little as a half day).

I had a claim, now what?

We know that “stuff happens” and there will be the unfortunate instance where you will have a claim to report. The majority of our companies have 24/7 claim centers and we would first advise you to call your insurance company in which you had the claim and report it to an authorized representative. That being said, there are some advantages to calling our office to speak to us about your claim. Our dedicated agents can advise you on what the effects of filing your claim would be, and explain how the claims process works. Hopefully taking the headache out of what already is a painful process. If it is an emergency, you should call your insurance provider directly, to expedite the process.

Got a Billing Question?

If you receive your billing directly from the insurance company, then they will have a billing department to answer any of your immediate questions. If you feel more comfortable calling us, then we would certainly enjoy hearing from you and take care of any questions or changes you might need. Our contact information is at the bottom right hand side of the page.

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