Health and Life Insurance

Health Insurance

Health insurance helps you get the care you need and protects you and your family from financial losses if you get sick or injured.

Most people must have health insurance that meets federal coverage standards or pay a tax penalty. Health plans provided by your employer and most state or federal government health plans (Medicare, Medicaid, CHIP, TRICARE, and some veterans’ health programs) usually satisfy this requirement.

Open enrollment. You usually must buy health insurance during the annual open enrollment period. The open enrollment period is from November 1 to January 31 each year. You may qualify to buy health insurance at other times of the year if you lose existing coverage, or have life changes like getting married, getting a divorce, or having a baby.

Preexisting conditions. Health insurance companies must sell a plan to anyone who applies during the open enrollment period. Companies may not deny you coverage or charge you more because of a preexisting condition or disability.

When deciding your premium, insurance companies may consider only your age, where you live, whether you smoke or use tobacco, and whether the coverage you’re buying is for an individual or a family. They may not consider your health status, medical condition or history, claims experience, genetic information, gender, disability, or other health factors.

Tax penalty. If you don’t get coverage, you’ll have to pay a tax penalty. You pay the penalty when you file your federal income taxes

Types of Health Insurance Plans

There are three major types of health plans: HMOs, preferred provider benefit plans (PPOs), and exclusive provider benefit plans (EPOs).

HMOs

An HMO will usually pay for your health care only if you use doctors and hospitals in its network. There are exceptions for medical emergencies and for medically necessary services that aren’t available in the HMO’s network.

You must choose a doctor from the HMO’s network to oversee all of your health care. This doctor is called your primary care physician. You must usually get a referral from your primary care physician if you want to see a specialist. One exception is that women don’t need a referral for a routine OB/GYN appointment if the doctor is in their network.

Some HMOs offer a point-of-service (POS) option that gives you more flexibility to choose your doctors. You’ll still have to choose a primary care physician, but you may go to out-of-network doctors without a referral. If you use doctors and hospitals that aren’t in your HMO’s network, you’ll have to pay more out-of-pocket for your health care. A point-of-service plan may exclude the option for out-of-network care for some medical conditions. Point-of-service coverage is usually offered as an add-on to the plan – called a rider – for an additional fee.

PPOs

A PPO is a network health plan offered by an insurance company. Although you can usually go to any doctor you choose, your out-of-pocket costs will be lower if you use doctors in the PPO’s network.

Doctors and hospitals in the network have agreed to charge a discounted price for services to the PPO’s members. Out-of-network doctors and hospitals haven’t agreed to the discounted prices and often charge more than what your PPO plan will pay for your care. You’ll usually have to pay this extra amount yourself. In addition, you’ll probably have to pay a separate deductible and higher copayments and coinsurance for any care you received outside of the network.

EPOs

EPOs negotiate agreements with doctors and hospitals to provide care to their members at a discounted rate. You must use doctors and hospitals in the EPO’s network.

The primary difference between EPOs and PPOs is that PPOs will typically pay some of the cost of your care if you go to doctors or hospitals outside of their networks, while EPOs will not. There are exceptions for medical emergencies and for medically necessary services that are only available outside the EPO network

Individual Health Plans

You can buy health insurance for your child or your entire family directly from insurance companies and agents. This coverage is called individual coverage because it covers individuals, not members of a group (the employees of a particular company, for instance). Insurance companies can’t deny coverage to anyone because of health factors, including a preexisting condition or disability.

Individual health plans have to cover a set of essential health services. These benefits include pediatric, oral, and vision services

Group Health Plans

Most Texans with health care coverage have an employer-sponsored plan. Employers often offer group health plans as part of an employee benefits package. Employers and groups that offer health coverage aren’t required by law to contribute toward plan premiums, but many do. Some insurance companies require employers to pay at least 50 percent of an employee’s premiums.

If your plan covers dependents, you can keep your children on it until they turn 26. Your children may stay on your plan even if they’re married. You can’t add a child’s spouse or dependent children to your plan, however. They’ll have to get separate coverage.

Texas law lets grandparents keep their dependent grandchildren on their health plans until the grandchild turns 25.

Your Rights in a Group Plan

Insurance companies and HMOs may not cancel or refuse to renew a plan based on the health of the group’s members. In a large group plan, they may use health factors to set premiums.

Insurance companies and HMOs may not offer or deny coverage only to select employees in a group. They must give employers at least 60 days’ notice before premium increases take effect and 90 days’ notice before discontinuing a plan.

Insurance companies and HMOs must allow new employees at least 31 days from the first day of employment to decide if they want to enroll in a plan. They must also offer a 31-day open enrollment period each year to allow existing employees to join the plan. Employees experiencing a life-changing event — such as a birth, adoption, marriage, or divorce — may enroll before the next annual enrollment period.

Factors that affect your Health Insurance Premium

Your age
Cost of medical care.
Deductibles and copays- Choosing a plan with higher deductibles and copays will likely reduce your monthly premium. But you’ll have to pay more out of your own pocket if you need health care. If you choose a higher deductible in exchange for a lower premium, consider setting aside the money you save to ensure you can afford the deductible. Some plans offer health savings accounts for this purpose

The above Texas Health insurance descriptions are meant to supplement, but not replace, the coverage detailed in your individual policy. Please refer to your actual policy contract language for coverage details.

At Owners Insurance Agency LLC we have a diverse range of products from health insurance carriers such as; Blue Cross Blue Shield of Texas, Cigna, Molina, Humana, Aetna, United Healthcare etc. If you need an Individual Health Plan or Group plan, please contact us today at (469)878-7535 or submit an online quote

Life

Life insurance provides money to your family after you die to help them pay for burial costs, living expenses, bills, and education. Some types of policies can also provide benefits while you are still alive through cash values and accelerated benefits.

Not everyone needs life insurance. To decide whether life insurance is a good choice for you, ask yourself the following questions:

Do you need to replace your income to provide for your spouse, children, or other family members?
Do you have debt, such as a mortgage, credit cards, student loans, or other debt?
Do you want to help your children pay for college?
Will your family need money to pay for your funeral costs or the cost to settle your estate?
Do you have a large estate that could be subject to state or federal estate taxes?

If you answered yes to any of these questions, you should consider buying life insurance.

Types of Life Insurance

Term Life Insurance

Term life policies are typically cheaper and less complicated than permanent life policies. There are two types of term life policies, annual renewable term and level term:

Annual renewable term is a one-year term where the premium adjusts each year based on your age when you renew your policy.
Level term is a policy that is sold with term periods of five, 10, 15, 20, 25, 30, or more years. The premium is designed to be the same during the period of the term. Some level-term policies guarantee that the premium won’t change, but other policies only guarantee that the premium won’t change for a few years even though the term may be for a longer period. It’s important to read the policy to know how long your premium is guaranteed to be the same.

Term life insurance policies typically only provide a death benefit. If you die during the term, your beneficiaries get the death benefit. Term policies don’t usually include a cash value or a savings component and aren’t designed to provide coverage for your entire life.

Permanent Life Insurance

Permanent life policies usually have higher premiums because they provide coverage for your entire life and have other features and benefits. The main feature of most permanent life insurance is a cash value or savings component that grows over time and may be withdrawn, invested, or borrowed against during your lifetime

Types of Permanent Life Policies

Whole-life insurance remains in effect for your entire life unless you cash the policy in or stop paying premiums. The policy is guaranteed renewable so you never have to renew the policy.

Premiums in a whole life policy generally are guaranteed for the lifetime of the policy. The premium is used to pay for the cost of insurance, the company’s expenses, profit, and to increase the cash value

Universal life insurance allows you to choose the amount of coverage, the amount of your premium, and the cash value you build. As long as you make your premium payments and you don’t withdraw or take a loan against the cash value, the interest rate your cash value earns doesn’t decrease. The policy may remain in force until the maturity date, which is generally age 95 or 100. At the maturity date, coverage ends and you get the cash value. Because of the flexible nature of this type of policy, review this policy annually to make sure it hasn’t changed. If it has, adjust the policy to allow it to continue to the maturity date.

Comparing the Major Types of Life Insurance

		Permanent Life
	Term Life	Whole Life	Universal Life
Premium	Low initially but may increase with each renewal.	Higher initially than term life. Normally doesn’t increase because it’s based on your age at the time the policy is issued.	Flexible premium payments.
Protects you for…	A specified period.	Your entire life if you keep the policy.	A flexible time period, which may be your entire life.
Policy Benefits	Death benefits only.	Death benefits, possibly a guaranteed cash value as well as a loan value.	Death benefits (that may include a cash value), possibly a cash value, and a loan value.
Advantages	Ability to buy more coverage for a lower premium.	Generally fixed premium amount. Cash value accumulation. You may have loan options for the cash value.	More flexibility with your payments. Cash value is credited with current interest rates.
Disadvantages	Premium increases with age. No cash value.	May be expensive to cover a short-term need. Usually little to no cash value in the first few years.	May be expensive to cover a short-term need. The payment isn’t guaranteed. Low interest rates can affect cash value, which may increase the premium payments.
Available Options	May be renewable or convertible to a permanent life insurance policy.	May pay dividends. May provide a reduced paid-up policy. Partial cash surrenders permitted.	Partial withdrawals are allowed. Increase and decreases to coverage amounts may be allowed

Factors that affect your Life Insurance

Insurance companies use a process called underwriting to decide whether to sell life insurance to someone and how much to charge them. The company will consider several factors to decide the premium to charge. Those include:

your age,
gender,
medical condition,
whether you use tobacco, and
your hobbies and occupation.

Younger people and people who are in good health, don’t use tobacco, and don’t have a hazardous hobby or job will have lower premiums because the company expects that these policyholders will live longer. People who are older, have health problems, use tobacco, or have a hazardous hobby or job will pay more.

Companies may charge you a higher premium or decide not to sell you a policy because of your potential risk.

Annuities

An annuity is a contractual financial product that is designed to accept and grow funds from an individual and then, upon annuitization, pay out a stream of payments to the individual at a later point in time. The period of time when an annuity is being funded and before payouts begin is referred to as the accumulation phase. Once payments commence, the contract is in the annuitization phase.

There are two primary types of annuities: fixed and variable annuities. Each type provides certain features.

Fixed annuities have a guaranteed minimum interest rate. The money you invest and your earnings are guaranteed not to lose money.
Variable annuities allow you to select sub-accounts that may range from conservative to very aggressive. The earning potential is greater with a variable annuity, but so is the risk. The money placed in a variable annuity isn’t guaranteed and you could lose money.

Currently, at Owners Insurance Agency LLC we are only offering fixed annuities.