Tuesday, December 7, 2010

Warning Signs for your Elder Loved Ones

What to Do if You See These Signs

Contact us for your elder care needs in Greenwich, New Canaan, Fairfield, Westchester, Westport Connecticutt 
elder care in connecticut

Steps to take once you have realized a loved one might benefit from supportive services.

    * Talk with your loved ones if you have any concerns about their health and safety. Knowing that you're concerned about their health may be all the motivation they need to see their doctor. Some people may need a little more encouragement, so let them know that you care about them and that you're worried. Consider including other people who care about them in the conversation, such as other relatives, close friends or clergy.

    * Work on solutions to calm their fears.  Many people have a fear that they are going to be sent to a nursing home.  But that is only for the most intensive care. There are so many other options to empower a person to live fully.   Work to develop solutions to problems around the home. These could arrange from assistive devices, in-home technology or at-home services.

    * In talking with your loved ones, you might decide that it's time for them to get some help around the house. Home service workers can help with tasks, such as errands and cleaning, or you might want to explore an assisted living community.

    * If your loved ones aren't willing to listen to your concerns or if they dismiss your claims, call their doctor for guidance. Some signs of medical problems aren't easily spotted in a doctor's office, and your concerns may help the doctor understand what to look for in their next visit.  The doctor won't discuss private information with you unless the person has given the doctor permission to discuss their care with you. However, their doctor or health care provider may be glad to hear your insights. The doctor may also want to make sure he or she is allowed to speak with you regarding your loved ones’ care. In the United States, patient privacy is governed by rules often referred to as HIPAA, or the Health Insurance Portability and Accountability Act. You will likely have to fill out a form stating that you can discuss this person’s medical information with their doctor or doctor's staff

Tuesday, November 16, 2010

How On Hold Marketing Messages can help your business

Most people agree that silence is not what their customers should listen to on hold. But if that’s
where your on-hold strategy ends, your business is missing out on a huge opportunity. On-hold
marketing messages
are the most cost-effective tool in your advertising arsenal. And with a little
planning and creativity, you can speak to your callers—your captive audience—in a way that’s as
effective as it is affordable.
Because many businesses are hesitant to admit that they sometimes have to place customers
on hold, on-hold messaging has a negative connotation. Consider this: if you prefer not to put
customers on hold, what could your business gain by improving customers’ on-hold experience?
You could rely on a more generic message, such as "Thank you for your patience. Your call is
important to us. Someone will be with you right away."
Or, you could use your customers’ time on-hold to give them valuable information they need to
know. Almost every business can benefit from on-hold messages, even if the message
campaign is not based on selling information. Because the caller has already contacted you,
they’ve demonstrated their interest in your services. You don’t have to “sell” them on the
benefits of the company they've called, and can use that opportunity to share valuable tips,
inform them of new products and services and more.
On-hold messages can focus on customer service topics, or even facts and statistics that are
entertaining and informative. Remember that you have a captive—and usually agreeable—
audience. With that in mind, the on-hold opportunities are as diverse as your clientele is large.
The Top 5 On-Hold Messaging Secrets
You have America’s largest captive audience…they’re on hold, they’re listening!
You have a targeted demographic and can be assured that virtually every person
placed on hold is someone you want to talk to.
Direct mail gets ignored and radio and TV ads go out to thousands of people who may never have a need for your service.
You can promote specials easily. Try using a feature like “When we return to the
line, ask us about our (discount on tire rotation and oil changes). You’ll be surprised
by how many people are listening!
Contact American On Hold today, so you can entertain potential and existing clients while you educate them on your
company. Promote the “I didn’t know you did that!” aspects of your business. Up-sell!

Monday, November 15, 2010

Tips about California Individual Health Insurance, Before you Buy

We are a health insurance company that provides Medicare Advantage and Medicare Supplement Insurance in Portland, Oregon. But, we wanted to share some facts about purchasing Individual Health Insurance in California.

Are you a resident of California and looking for the right health insurance plan? If insurance benefits are not offered through your employer most likely you now find yourself doing a bit of research on California Individual Health Insurance. With so many health plans available - where do you start? What Insurance Company do you choose? If you are asking yourself these types of questions you are not alone. Use the following checklist to ensure you don't get lost on the road to applying for California Individual Health Insurance.

Identify your need

Choosing the right insurance plan starts with knowing why you need the coverage. Are you looking for catastrophic only coverage? A policy that provides more up front benefits such as office visit co-pays and prescription drug coverage? Or maybe you are starting a family and seek a policy that offers maternity benefits.

Know your budget and what benefits you get for the price

Once you have identified your need you then should take a look at your budget. Many people don't evaluate insurance benefits close enough and end up paying more for coverage than they have to. For example you don't want a policy that offers first dollar prescription co-pays when you are healthy 364 days a year. Strip the plan down a bit and go with catastrophic only coverage. Your bank account will thank you.

When choosing a catastrophic plan take a look at the out-of-pocket maximum. How much risk are you willing to take on in the case of an accident? Once you have an idea of this figure you then can compare different health insurance companies and the monthly premiums vs. out-of-pocket maximums.

If you are the type of person that sees the doctor more frequently and/or requires prescription drug coverage be aware that some of these policies have limitations. Some plans will only offer several office visit co-pays per year. Ideally you want unlimited office visits at fixed co-pay if the monthly premium is reasonable. Prescription drugs are often times assessed a brand name pharmacy deductible in which you pay full price for brand drugs until it is satisfied. If a generic prescription is available you may want to consider it because generally generic Rx are exempt from a deductible and covered right away at a fixed co-pay.

Selecting a policy with maternity benefits is similar to choosing catastrophic coverage. In the case of a normal delivery you can expect to pay up to the policy maximum. This is the general rule of thumb excluding HMO plans that will charge you per day that you are in the hospital. It goes without saying that you will want to choose the maternity plan that leaves you paying the least out-of-pocket.

Understand how effect dates work

An important part of applying for a California Individual Health Insurance plan is determining when you want the coverage to take effect. With an individual plan you have to be underwritten based upon your health history. For a person with squeaky clean health this process can go rather quickly. Approvals can happen the same week or sometimes the same day. It all depends on the insurance company once an application has been submitted. For the individual who has health conditions the underwriting process can take longer due to the insurance company having to obtain and review medical records from your doctor. On the average this can take up to a month and sometimes longer depending on how fast the company can obtain your records.

Thursday, November 4, 2010

Medicare Supplement Insurance Principles Explained

Texas Medicare Supplement
Our Texas Based company specializes in Medicare supplement insurance. This article is informative and not just for Texas Medicare Supplement Insurance customers. We hope that we provided clear information that will address and questions that you previously had about the supplement. 

Medicare is an incredible system of health coverage that is offered to senior citizens each and every day as they turn the required minimum age. This form of health coverage was established to ensure that anyone that is of retirement age and not employed could enjoy the benefits of having health coverage in order to maintain and live a healthy and active lifestyle. The use of supplemental insurance to alleviate costs that are not covered under this plan has become incredible important which requires the knowledge of the important aspects of Medicare supplement insurance.

Medicare medical coverage is known to only cover up to 80% of health expenses that are often associated with this plan. The other expenses that are not covered under this plan are often paid out of pocket by the consumer which could quickly add up to be rather expensive over time Thus, many Medicare recipients often purchase a supplement insurance plan to help cover the remaining 20%.

Fortunately, there has been an increased awareness of these remaining out of pocket costs which has given rise to an incredible amount of competition for this form of coverage. This could also make the decision making process a bit confusing for some. Thus, understanding what this type of coverage is all about helps the decision making process overall.

There are over 12 different types of supplement coverage options available today that all provide varying degrees of coverage. These are labeled A through L and are all priced at different levels. Each level provides a different co payment and premium amount as well as a different level of deductible as well.

One of the more affordable plans that is out there today is the Medicare Select plan. This is a plan that offers very affordable premiums and co payments for those on a very limited and restricted budget. Perhaps the only downside to this plan is that there are only very specific doctors and hospitals that are covered.

A very popular aspect of these types of plans is that there is very little flexibility in how they are constructed. Basically, this means that there truly are very few aspects of competition present which could make the selection process a bit easier. Each provider must offer the same levels and forms of coverage.

Medicare supplement insurance should be purchased within the first six months of receiving Medicare. Basically, this helps to ensure that no one is able to deny coverage based upon pre existing conditions. Thus, remain vigilant and purchase this coverage immediately.

Tuesday, October 5, 2010

The Magic Of Believing In Yourself

About six years ago, my oldest daughter Dana graduated from Loyola University School of Nursing, took her boards and became an R.N.

Her dream was to be a nurse in the pediatric intensive care unit at Children's Memorial Hospital in Chicago.

As she shared her dream with others, everyone told her that it doesn't happen that way. Her friends said, "You're not being realistic, you have no experience...and you want to start at one of the best hospitals in the country? What are you thinking?

They said, "Nobody gets hired for the pediatric intensive care unit at Children's right out of nursing school. Nobody."

They said, "Get several years of good experience, first, and then go for Children's. You have to be practical about this."

Dana listened to them. After all, they were her friends and some of them were her advisors. So, she listened to them.

Then, she didn't listen to them any longer.

She listened to herself.

She wanted to start her healthcare career, not just at Children's hospital, but in their pediatric intensive care unit!

So, she went for what she wanted, knowing it was a stretch. Dana interviewed and sold herself during the interview.

Despite not having any experience, Dana got her dream job. She's been there about six years now and loves what she is doing and where she is.

Dana is living her dream.

Now, she's working on her master's degree to become a Nurse Practicioner.

Good for her.

How did Dana get to where she is today?

There are many variables involved, no question about it.

But, here's one that we can all be reminded of:

You have to believe in yourself first.

If you do, others will.

If you don't, it can be a crap shoot.

Guess which one Dana chose?

Read more from the author here:

Wednesday, September 29, 2010

You Can File a Personal Injury Suit Even If You Can't Afford an Accident Attorney

Every Victim of an Accident or Personal Injury Deserves Attorney Representation

It happens to thousands of people every day. Through no fault of their own, they are involved in a vehicle wreck or accident that causes serious injuries. These injuries keep them from being able to work and provide for their families. Because these people cannot afford to pay their bills, they feel certain they cannot afford an attorney. They suffer because they don't realize that they can get help.

While many survive their accidents, some do not. If that person was the primary breadwinner of the home, their families are left behind to struggle to pay the bills without their income. And if that person was in the hospital before passing away, there are medical bills that have to be paid.

Some families in these situations give up and file bankruptcy. Some just let their credit be ruined because they cannot pay the bills. It doesn't have to be this way.

A contingent fee arrangement allows people to file suit against the powerful corporations and insurance companies without having to pay an attorney any up front costs. Here's how it works: The attorneys and the client will agree to share the settlement amount if there is one. An agreement will also be made as to how the expenses are paid. But here's the best part-in most cases the client does not pay anything unless a settlement is reached.

How Can Personal Injury Attorneys Offer This?

Because the accident has left them available to work, most of the people who need a Houston personal injury attorney don't have the funds to pay legal fees. A large number of personal injury cases in the United States are "no win, no fee" agreements.

An attorney that takes on one of these types of cases believes that he or she can win it. An attorney is not going to take on a case that doesn't have merit. To do so would be misleading to the client. Most attorneys will not take on a case they don't feel they can win or they feel is frivolous. Despite common misconceptions, attorneys don't want to file frivolous lawsuits that place a burden on the court system.

How Does a Contingent Fee Arrangement Work?

A client must sign a contingent fee agreement. This will outline how much the attorney will invest in the case and what steps he or she will take. Most cases never make it to the courtroom but are settled. The agreement also outlines how a settlement will be divided once the case is won. This includes how much the attorney will get in fees and for expenses incurred during the case.

More and more clients are demanding contingent fee agreements after their accidents. They are a win-win for the client since they are not out any money if they lose and they will receive a settlement for their pain and suffering if they win.

No one should suffer because of someone else's negligence. A contingent fee lawsuit with in Texas with a Houston personal injury attorney can help those who are injured physically, financially and personally in an accident.


The author has been serving clients with accident claims for 15 years. Contact us if you need a Malpractice Attorney in Boca, Boynton Beach, Jupiter or West Palm Beach.

Thursday, September 23, 2010

Workers' Compensation Insurance - What Employers Should Know

All U.S. employers, with very limited exceptions, are required to purchase Workers' Compensation insurance. This state-regulated insurance provides state mandated medical and lost wage benefits to employees injured during the course and scope of their employment.   Exceptions to purchasing this mandatory insurance include very small companies that do not meet the number of employees requirement, or in some cases, very large companies that prefer to self-insure this risk. An employer's failure to comply with a state's requirements will trigger economic penalties and possible criminal prosecution.  A variety of Workers' Compensation insurance programs are available from the employer's risk finance perspective.

Exclusive Remedy & Employers' Liability

Although each state's regulations differ, they all share a common purpose. They provide an "exclusive remedy" in the form of a "no-fault" program for compensating employees in the form of medical benefits and lost wages in connection with injuries that arise in the course and scope of their employment. While Workers' Compensation insurance responds to the "no-fault" consequences of workplace injury, Employers' Liability insurance, which is typically joined with Workers' Compensation policies, provides coverage for common law claims against the employer by the employee, their family or third-parties, if the claimant or plaintiff can meet the legal standard in their jurisdiction for establishing that the injury was caused by the employer's negligence, gross negligence, recklessness or willful conduct.

The Broad Landscape of Special Funds and State Programs

Many states provide special funds to pay workers' compensation benefits to injured workers employed by companies that failed to purchase insurance. Assigned risk pools or insurers of last resort are also available for employers that commercial insurers consider too risky.

Monopolistic States

There are currently four monopolistic states: Ohio, North Dakota, Washington and Wyoming. Puerto Rico and the U.S. Virgin Islands also operate under a monopolistic structure. These states legislated requirements that Workers' Compensation insurance be provided exclusively by the state's compulsory program. Commercial insurers may not offer Workers' Compensation insurance in those four states, yet at least two of the states do allow limited opportunity for self-insurance for well-capitalized employers.

Competitive State Funds

In contrast to monopolistic state programs, Competitive State Funds are state-owned and operated insurance facilities that compete in the open market with commercial insurers to underwrite Workers' Compensation insurance solely within their respective state.

Arizona, California, Colorado, Hawaii, Idaho, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, Montana, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, and West Virginia operate Competitive State Fund programs.

Second or Subsequent Injury Funds

In most states it's illegal for an employer to refuse to hire a prospective employee or terminate an employee if they have previously filed a workers' compensation claim.  To reduce the possibility of this form of discrimination, some states established a Second Injury or Subsequent Injury Fund. The purpose of these funds is to limit an employer's (and their Workers' Compensation insurer's) exposure by reimbursing or covering the Workers' Compensation benefits paid because of an aggravation or recurrence of a previously existing injury. Reimbursement eligibility requires that the injury must result from a qualifying permanent partial pre-existing disability, illness or congenital medical condition that may hinder person from obtaining employment.

Insurance Premium Calculation - The Loss Experience Mod Factor

This is a complex and often misunderstood concept that has a major effect upon a company's Workers' Compensation insurance premiums. On a general level, it is essentially a comparative analysis of your company's Workers' Compensation loss history for the prior three years against companies within the same or similar industries.

The standard Experience Mod, which is explained below, is calculated by the National Council on Compensation Insurance (NCCI). Employees are classified by standard identification codes depending upon their occupation. Depending upon an employer's size and diversity of operations, many classification codes may be involved in the analysis.

Simply stated, the neutral point in the rating curve is 1.0. If a company's Experience Modification Factor ("Mod") is greater than 1.0, the employer is issued a "Debit Mod" meaning the premium will be increased by a certain mathematical factor. Alternatively, if the loss history is better than expected or lower than 1.0, the employer receives a "Credit Mod" factor that will decrease the Workers' Compensation premium.

A Premium Calculation Illustration  Using a simple example, suppose the employer only has one classification code for all employees, all of whom work in the same state, and the Workers' Compensation expected loss rate or base premium rate (as established by the state in which the company's employees are located) is $3 for every $100 of payroll.

If the employer has a Mod factor of 0.70, the premium will be calculated as 0.70 x $3 = $2.10. This means the employer is paying $2.10 per $100 of payroll, while its competitor peer group, on average, is paying $3 per $100 of payroll.

Assume the annual payroll for this employer is $2 million, the result is the employer would pay $42,000 in premium versus its competitors with a Mod of 1.0 paying $60,000 for the same coverage. Conversely, if the employer in this example had a Mod of 1.5, the premium would be 1.5 x $3= $4.5 per $100 of payroll. Using the same $2 million annual payroll, the employer in this case would pay $90,000 in annual premium while competitors with a 1.0 Mod would be paying $30,000 less for the same coverage. It's easy to appreciate how these Credit or Debit Mods will have a significant impact upon a company's bottom line, particularly as annual payrolls reach significant levels.

Many factors go into the actual calculation of a Mod including the company's loss frequency (number of losses), loss severity (the cost of the losses), and an estimate of losses that are characterized as Incurred But Not Reported (IBNR), meaning expected losses that have not yet materialized into actual workers' compensation claims.

Medical-Only vs. Lost-Time Claims

When calculating an experience Mod, Medical-Only claim reserves are generally factored at about 30% of ultimate value. Lost Time or Indemnity claims are treated very differently. The literature on calculating experience modification factors states that the first $5,000 of a Lost Time claim ultimate reserve is factored in at 100% with discounts applying above $5,000, including a catastrophic claim cap limit. Therefore, the frequency of Lost Time claims is a real driver of adverse experience. If a company has one Lost Time claim valued at $50,000, it will have less of an adverse affect upon the Mod factor than twenty Lost Time claims valued at $2,500 per claim.

The difference between how these two types of claims affect the Mod should be a strong incentive for employers to implement modified duty programs, with particular attention given to getting employees back to work during the mandatory benefit waiting period, whenever possible. This will cause the claim to be reclassified to "Medical Only" thereby reducing the multi-year adverse impact upon the company's Workers' Compensation insurance premiums.

Claim reserve management is critically important as having over-reserved claims will exponentially affect your Mod factor and correspondingly increase your premium. Having under-reserved claims is also no benefit, as the insurer's audit may result in an unexpected assessment and, of course, increased premiums going forward. Periodic reserve evaluation by a qualified professional should ensure that over-reserved cases are negotiated downward to a reasonable level and under-reserved cases are reserved properly.

Loss Prevention

Loss Prevention is the best way to keep insurance premiums in check. The process can take many forms but essentially involves identifying potential areas of work injury risk and applying techniques to eliminate or substantially reduce the risk that an injury will occur.

Identification of potential causes of risk through performance of a workplace risk assessment is the first step. This process includes critical analysis of procedures as well as physical inspection of facilities and work environments, and discussions with operational personnel and key managers.

Once the causes of potential loss have been identified, modifications can be implemented to operational and business practices in order to reduce the associated risks. The assessment process should be performed by qualified consultants, combining qualitative elements and quantitative metrics including specifications of the physical requirements of each function and the associated loss costs.

Findings should be reviewed with key stakeholders. After agreed upon modifications to operational programs and/or safety programs have been implemented, it's important to monitor results and make adjustments to the preventive measures. Periodic re-testing is important to ensure optimal results are consistently achieved as the company develops. This process has unique relevance in an acquisition scenario

Loss Control

Loss Control is the process of reducing or mitigating the effect of losses once they occur. Similar to loss prevention safety programs, loss control should encompass well-formulated procedures to respond to various loss situations. The most common examples of loss control are obtaining immediate medical attention for injured workers and having a limited duty return to work program. Employers should conduct a post-loss analysis of the factors that precipitated the loss to determine whether modifications to the loss prevention plan are appropriate. Any post-loss control program should include a process for coordinating medical care to ensure that appropriate medical treatment is received timely so as not to exacerbate a condition while managing medical costs to avoid any unnecessary expenses. Additionally, developing a close working relationship with insurers to deal with potentially fraudulent claims, and implementing an early return to work or modified return to work program all factor into keeping losses at their lowest possible level.

OSHA Focuses On Ergonomics

The Occupational Safety & Health Administration ("OSHA") publishes a variety of guidelines on the topic of workplace ergonomics for various industries and jobs. OSHA has announced plans to heighten its enforcement of ergonomics under the General Duty Clause which requires employers to "...keep their workplaces free from recognized serious hazards, including ergonomic hazards."

OSHA Enforcement has stated:

 Even if there are no guidelines specific to your industry, as an employer you still have an obligation under the General Duty Clause, Section 5(a)(1) to keep your workplace free from recognized serious hazards, including ergonomic hazards. OSHA will cite employers for ergonomic hazards under the General Duty Clause or issue ergonomic hazard letters where appropriate as part of its overall enforcement program. OSHA encourages employers, where necessary, to implement effective programs or other measures to reduce ergonomic hazards and associated musculo-skeletal disorders ("MSDs"). A great deal of information is currently available from OSHA, NIOSH, and various industry and labor organizations on how to establish an effective ergonomics program, and OSHA urges employers to avail themselves of these resources.

Workers' Compensation costs have a direct bottom line effect upon all enterprises. Managing those costs to the optimally lowest level requires operational risk assessment, planning, education, an effective return to work program, continual evaluation and active management of loss reserves and third party claims administrators. Experienced insurance professionals are an employer's best resource for minimizing the adverse effects of work-related injuries upon profitability.


The author is a Chartered Property and Casualty Underwriter