Keeping An Eye Out For Health Insurance Fraud In Texas

Insurance fraud. It happens daily. There are a number of bogus health insurance companies and agents in Dallas, Houston or anywhere else in Texas who will take your money and run. So, before you purchase health insurance for your employees or your business, make sure the insurance company you’re dealing with is legitimate. Start by checking your insurance agent’s credentials to be sure he or she is licensed to sell insurance in Texas.An insurance scam artist may act without a license or use fictitious documents to appear legitimate. The following information will provide what you need to make the right decision when purchasing health insurance for your business or individual employees. The scammers are out there just waiting for you to take the wrong step. Make sure you know what’s waiting for you before you get scammed out of a lot of money.In the last couple of years, the Texas Department of Insurance (TDI) has shut down 51 agents and 10 companies for selling unauthorized insurance. There are currently 376 open investigations against suspected unauthorized insurance scams in Texas.The first thing is to check to see if a potential company is authorized to sell insurance. Then check to see if your insurance agent or agency is licensed. If you fail to find your company or insurance agency, don’t assume it’s unauthorized. Check with your agent for more information. Or verify by calling TDI’s toll-free Consumer Helpline weekdays between 8 a.m. and 5 p.m. at 1-800-252-3439. Insurance company data is usually updated at 7 a.m. each business day.Businesses, school districts and individuals are bilked out of thousands of dollars each year by scam artists who misrepresent themselves as insurance agents. So, while the search for affordable health insurance can be a daunting task, don’t blindly follow an agent. But did you know you run the risk of purchasing a phony policy even if you work with a legitimate agent? At times, even experienced agents can unknowingly sell illegal insurance products. Though honest agents will do their level best to avoid such circumstances, it can still happen. Worst of all, you could be on the hook for a wide range of costs and expenses that you thought your insurance was covering.The typical health insurance scam moves pretty fast. Scam agents flood the market to help generate as many quick sales as possible. Often, payments will be requested up front to help ensure they get as much money as possible before they disappear. After the fake agents have reached their goal, they simply sit back and watch the monthly payments roll in. Then, just as quickly as they appeared, they are gone, only to re-appear later under a new name and a new scam. The individual or company may never know they’ve been duped until, after thousands of dollars in premiums have been paid, they then try and file a claim.It’s important to know what to look for. Here are some of the most common signs that an insurance company may be a scammer:• They claim extremely low rates, or offer minimal or no underwriting.• The health plan will accept almost anyone, including those with pre-existing or serious illnesses.• The plan claims to be federal, not state regulated. (ERISA or union plans, for example)• Sales pitches that avoid the word “insurance” or the use of certain insurance terminology even though it operates like insurance. For instance, it pays “consultant fees” instead of commissions, or refers to premiums as “contributions.”• The product claims to be “fully funded,” “fully insured,” or “reinsured” but agents are not told the name of the carrier insuring or underwriting the product.Sometimes the path may seem clear and the choice easy, but in an effort to save money, there may be some things that aren’t clearly visible at first glance. So how can you avoid the scammers? Check out each insurance company and agent you deal with. It only takes a little extra time, but the effort could possibly save you headache, heartache, and thousands of dollars down the road.If you’re a small business owner who would like to offer affordable health insurance plans to your employees, but can’t afford group health insurance, you should consider offering your employees the revolutionary, comprehensive individual health insurance solutions created by Precedent specifically for young, healthy individuals. If you’re interested in an individual health insurance plan on your own, you should also take a look at Precedent.Backed by American Community Mutual Insurance – which has been in business nearly 70 years and is B+ (Very Good) rated by independent A.M. Best – Precedent offers affordable, individual health plans with catastrophic coverage, but without a high deductible, and we’ll offer these plans to your employees at a discount. For more information, visit us at our website, [http://www.precedent.com]. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.

Out On The Edge – The Lack of Health Insurance Benefits For Nonstandard Workers In Texas

A 2005 Commonwealth Fund white paper reported on two important trends in the U.S. workforce – the increasing prevalence of workers in part-time, temporary, contract or non-standard positions, and the decline in access to employer-provided health insurance.The fact that fewer and fewer individuals in Dallas, Houston and throughout Texas are covered by health insurance as well as the diminished quality of coverage brought about by higher copayments and deductibles has gotten a lot of attention. At the same time, there has been remarkably little attention paid to the status of nonstandard workers, who are particularly vulnerable because their employment status often excludes them from employer-based coverage. This increases their reliance on family members’ policies, public coverage or leaves them without insurance completely.Nonstandard workers currently make up approximately 25 percent of the nation’s workforce, totaling 34.3 million workers. Part-time workers make up the biggest category within this group, followed by self-employed independent contractors and direct-hire temporary workers. Nonstandard workers also include on-call and day laborers, temporary help agency workers, independent contractors, and contract company workers.While access to employer-sponsored health insurance is on the decline for all workers, it is an especially serious problem for nonstandard workers. A recent study showed that 74 percent of standard workers have health insurance through their jobs, compared to only 21 percent of nonstandard workers. Because of this disparity, nonstandard workers are thought to be uninsured at twice the rate of standard workers. Nonstandard workers also rely on government insurance at five times the rate of regular workers and are insured through a spouse’s health insurance plan at three and one-half times the rate of regular workers.In addition to being less likely to be offered employer-sponsored health insurance, nonstandard workers are also less likely to take up employer-sponsored coverage when it is available. About 87 percent of regular full-time workers are offered health insurance, compared with only 40 percent of nonstandard workers. Among those nonstandard workers who are eligible for employer-based plans, only 54 percent choose them, while the selection rate for standard workers is 85 percent. Nonstandard workers who turn down coverage said it was either because they had coverage through another source or because the plan was too expensive.Families of nonstandard workers are also affected by their spotty insurance coverage. Only 15 percent of children and 16 percent of spouses of nonstandard workers have health insurance through the nonstandard worker’s employer. In fact, standard workers’ children and spouses were covered by the spouse’s employer at three times the rate that they were covered by the nonstandard worker’s employer. Almost one in five family members of nonstandard workers was uninsured (18% of children and 16% of spouses). A significant share — 10 percent of children and 6 percent of spouses — relied on public health insurance for coverage.Because of the rising cost of health insurance, some employers and individuals — both nonstandard workers and regular employees — are turning to low-cost products like high-deductible health insurance plans, limited benefit health insurance and medical discount cards. While these options are typically more affordable than comprehensive health insurance, coverage is limited. A recent Iowa Policy Project (IPP) Survey of Fringe Benefits and Nonstandard Work found that 18 percent of nonstandard workers had discount cards, but no insurance coverage. However, almost all these workers mistakenly reported that their discount card was a health insurance policy. This has led to suggestions that rates of uninsurance may actually be underestimated.The Iowa report concludes that improving access to health coverage for nonstandard workers will require addressing three issues: regulating employer-employee relationships to ensure that nonstandard workers enjoy the same individual and collective rights as conventional employees; strengthening the foundation of employment-based health insurance, making it easier for employers to offer coverage and workers to afford it; and expanding alternatives to employment-based coverage.Current policymakers need to start identifying the obstacles facing the uninsured and underinsured, as well as each individual’s potential for eligibility, according to income, job tenure, or firm size. It’s going to be a formidable task to provide nonstandard workers with access to group-based insurance — by increasing access to conventional job-based coverage, creating new health insurance purchasing pools, or by expanding individual health insurance alternatives.Although most individuals are covered under employment-based coverage, there’s no requirement that employers provide it. Most employers — especially those with fewer employees— have strong reasons to avoid taking on the health insurance burden. Some small business employers have responded to rising health insurance costs by shifting more coverage costs to employees or dropping coverage altogether.If you’re a small business owner who would like to offer affordable health insurance plans to your employees, but can’t afford group health insurance, you should consider offering your employees the revolutionary, comprehensive individual health insurance solutions created by Precedent specifically for young, healthy individuals.Precedent offers affordable, individual health plans with catastrophic coverage, but without a high deductible, and we’ll offer these plans to your employees at a discount.For more information, visit us at our website, [http://www.precedent.com]. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.