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Serving Farmingdale, Garden City, Port Washington, Glen Cove, Long Beach, Yonkers, New York City, Mount   Vernon, White Plains, Deer Park, Hauppauge, Massapequa, Bronx, Brooklyn , Queens, Manhattan, and Staten Island  

What You Need to Know if You Administer a Group Benefit Plan

Due to the recent decision by the Supreme Court to uphold the many of the changes of the Affordable Care Act, employers need to know important mandates or face strict repercussions and/or penalties. There are several mandates that have already passed such as raising the dependent age to 26, eliminating pre-existing condition exclusions for minors, and banishing lifetime benefit caps. These mandates greatly affected the way the carriers provide coverage, but what about the employer? What are the mandates plan sponsors have to follow?   Read More>>

Breaking News: Supreme Court Upholds Core of Affordable Care Act

U.S. Supreme Court Preserves Most of Affordable Care Act; What Does it Mean for Brokers?

June 28, 2012 - The U.S. Supreme Court today upheld as constitutional almost all of President Barak Obama’s health care overhaul, preserving most of a law that expands insurance to millions of people. A five vote majority on the court ruled that the Patient Protection and Affordable Care Act’s “individual mandate” was allowable under the taxing power that the Constitution grants to Congress. The individual mandate, the law’s backers say, is needed to cover 33 million uninsured Americans.  Read More>>

Health Care Reform Section

Timeline - What’s Changing and When

Small Business Tax Credit   by the IRS

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Employee Benefits

Which dental plans provide coverage to dentists that don’t accept insurance?  Find Out >>

What is the maximum contribution to an FSA in 2012?  Read >>

What are the different types of pension plans?  Explore >>

Large group essentials - Show>>

Insurance Talk

How should an insurance certificate list an additional insured?  Learn >>

Is the denial of a claim final to receive recovery in the event of a loss?  Check it out>>

Five important provisions of a liability policy - What are they? >>

Workers’ Compensation

Are your payrolls classified correctly?  Read about it>>

What injuries are covered and what are the benefits? Learn>>

Which states require DBL insurance? Find out>>

Understanding the experience modification factor - Show >>

Financial Planning

How does a whole life policy build wealth?  Learn how>>

Which is better–group or individual disability?  Find out>>

A recent study shows 60% of 65 year olds will need ltc - Read>>

Fixed versus variable annuities - Which is better? Show>>

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Featured Pages Throughout the Website

Our mission is to provide affordable, low costing insurance and employee benefit plans for individuals and organizations allowing them the financial liberty  to choose among the various products we offer.  We will seek the best value of coverage for our clients and for the professionals we work with.  We will make every effort to gain the necessary experience & education and to offer the insight needed to help us deal with the ever changing insurance and employee benefits industry.

We plan to commit more resources to train our staff to help ensure they provide the top quality service our clients and affiliates expect and deserve.  Our goal is to work with more diverse and progressive agencies and brokers to assist in the servicing and marketing of workers’ compensation, group health & dental plans, voluntary benefits, disability income, pensions, long term care, and life insurance for their clients.  We will aim to provide greater access to various programs including commercial liability, property, auto & truck insurance for  the many types of businesses and organizations across Long Island, Westchester, the Greater New York  Metropolitan  and the Tri-State Area.

We’re Going Green!  Find out more     

Join Our Team - Enjoy Your Financial Liberty  Selling Your Insurance Agency?  Talk to us…

Health Care Reform & the Role of the Insurance Broker

Over the past few years, there have been many changes in our industry, primarily due to the Patient Protection and the Affordable Care Act.  Due to these changes, there is much uncertainty with the future of our livelihoods and the health insurance industry.  Many carriers have either sold their accounts to other companies or have pulled their business from our area.  In the Greater New York area alone, we recently lost HealthNet, MDNY, Guardian large group, Cigna small group, and Horizon Blue Cross Blue Shield as carriers for group health insurance.  HIP and GHI merged to form Emblem Health.  Oxford Health Plans was purchased by United Healthcare and Empire and Anthem Blue Cross Blue Shield were taken over by Well Point.  There has also been talks about commissions being reduced and the terminations of broker contracts for those that don’t meet production requirements.  

Do the legislators that passed the Act really understand the brokers role?  

One of the major concerns in our industry is that the broker’s commission will be included within the new medical loss ratio requirements (MLR).  Essentially this means the carriers’ net income would be reduced by the amount of broker commission. The MLR requirements force the carriers to pay up to 85% of every dollar collected in premium to be paid out in claims. Therefore, as little as 15% is left to pay expenses such as payroll, rent, utilities, marketing, and our compensation.  

So what is it that we do for our clients?

Besides marketing and writing new business, our office and other brokers like us are actively engaged in servicing our accounts.  We are typically the first point of contact for the groups we write.  If there are questions regarding claims, billing, enrollment, terminations, COBRA, changes in legislation, and the list goes on–-we generally receive the phone call first. We also gather the proper documentation needed to maintain compliance such as obtaining the NYS-45 forms, Medicare and Medicaid cards, HIPAA certifications, etc.   

If our role is diminished by the recent legislation it will probably force the carriers to hire more employees or worse–outsource many aspects of the customer service elsewhere in order to maintain competitiveness.   Shouldn’t the government encourage more competition and fair trade?  Then why place restrictions, and increase regulation on an already heavily regulated industry?  This seems to be driving the competition out of our industry and out of business.  

Are we facing the same fate as travel agencies?  I hope not. Please share your thoughts and join our blog.  

Thank you, William F. Schaake, CIC, CRM  

October 15th Deadline

Organizations that provide prescription drug benefits to Medicare Eligible Employees through their group health insurance plan must notify CMS and its employees if the coverage is credible.  Read more >>

2014 Health Insurance Rates

Health Benefit Exchange

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Employers with 50 or More Employees

Key Provisions Under the Affordable Care Act for Employers with 50 or More Employees