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Monday, 3 August 2015

Health Insurance Policy

 
Health Insurance Policy
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. 

According to the Health Insurance Association of America, health insurance is defined as coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment.


A Health Insurance Policy

A contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (e.g. an employer or a community organization). The contract can be renewable (e.g. annually, monthly) or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or “Evidence of Coverage” booklet for private insurance, or in a national health policy for public insurance.

(US specific) Provided by an employer-sponsored self-funded ERISA plan. The company generally advertises that they have one of the big insurance companies. However, in an ERISA case, that insurance company “doesn’t engage in the act of insurance”, they just administer it. Therefore, ERISA plans are not subject to state laws. ERISA plans are governed by federal law under the jurisdiction of the US Department of Labor (USDOL). The specific benefits or coverage details are found in the Summary Plan Description (SPD). An appeal must go through the insurance company, then to the Employer’s Plan Fiduciary. If still required, the Fiduciary’s decision can be brought to the USDOL to review for ERISA compliance, and then file a lawsuit in federal court.

The individual insured person’s obligations may take several forms:
Premium: The amount the policy-holder or their sponsor (e.g. an employer) pays to the health plan to purchase health coverage.

Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, policy-holders might have to pay a $500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor’s visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care. Furthermore, most policies do not apply co-pays for doctor’s visits or prescriptions against your deductible.
Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor’s visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.

Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.

Exclusions: Not all services are covered. The insured are generally expected to pay the full cost of non-covered services out of their own pockets.

Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan’s maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.

Out-of-pocket maxima: Similar to coverage limits, except that in this case, the insured person’s payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs. Out-of-pocket maxima can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.

Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.

In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the “usual and customary” charges the insurer pays to out-of-network providers.

Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized. Many smaller, routine services do not require authorization.

Explanation of Benefits: A document that may be sent by an insurer to a patient explaining what was covered for a medical service, and how payment amount and patient responsibility amount were determined.
Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan. Such plans are routinely part of national health insurance programs. For example, in the province of Quebec, Canada, prescription drug insurance is universally required as part of the public health insurance plan, but may be purchased and administered either through private or group plans, or through the public plan.

Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn’t pay. The insurance company pays out of network providers according to “reasonable and customary” charges, which may be less than the provider’s usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider’s standard charges. It generally costs the patient less to use an in-network provider.

We can resume health insurance terminology as the ‘provider’ as we can say it may be clinic, doctor, hospital, laboratory, pharmacy or health care practitioner. The person with the health insurance coverage’s, 'insured’ is the owner of the health insurance policy.

Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. Besides that, depending on the type of health insurance coverage either the insured pays costs out-of-pocket and is then reimbursed or the insurer makes payments directly to the provider. Health insurance is commonly included in employer benefit packages and seen as an employment perk in USA.

In some countries, health care coverage is provided by the state and is seen as every citizen’s right, such as Canada and United Kingdom. It is classed along with public education, firefighters, street lighting, public road networks, and police as a part of a public service for the nation.

In country like USA, we can see health insurance coverage is somewhat different from the others country. Health insurance is done by everyone, with the exception of some groups, such as veterans, elderly and/or disabled people. It is the individual’s responsibility to be insured. Most recently, Obama Administration has introduced laws making it mandatory for everybody to have health insurance, obviously there are penalties for those who fail to have a policy of some kind.

Everybody at some time in their life and often on many occasions surely will need some kind of medical attention and treatment. Whenever medical care is required, mostly the patient should be able to concentrate on getting better with their health, rather than wondering whether he/she has got the resources to pay for all the bills. Most recently, This view is becoming more commonly held in nearly all the developed nations.

Wednesday, 27 May 2015

Types of Life Insurance Policies

 
Types of Life Insurance Policies
Insurance companies have present different levels of policies to suit different needs of public. At the time of confirming to buy a policy, a person must know firstly the amount of premium he will have to pay, secondly time span of insurance, and thirdly.sum insured with or without bonus. The following are the types of life insurance policies:

Types Of Life Insurance Policies


  1. Whole life policy
  2. Endowment policy
  3. Term policy
  4. Other life policies

Types Of Life Insurance Policies


1) Whole Life policy
In this type of policy the insured have to pay premium throughout his life or up to limited years. The amount is paid to the nominee of the insured on his death. This done for the protection of nominee’s family. The rate of premium in the policy is low as compared to other policies of life insurance because amount is payable in the whole life. This type of policy has no financial gain to insured. It can be further classified into following types:
  • Ordinary whole life policy
  • Limited Premium whole life policy
  • Single Premium whole life policy

2) Endowment Policy
This type of policy is issued for a fixed specific period of time. Insured is payable to the policyholder on the maturity of the policy. Endowment policy is very popular because it makes provision for the security of the family. The following are the types of this policy:
  •  Ordinary endowment policy
  • Pure endowment policy
  •  Double Endowment policy
  •  Deferred endowment policy.

3) Term Policy
It’s a very old policy which is for 1, 2, 5 or 10 years. The money is paid back only after the death of the nominee. If the nominee survives more than the insured time than company will not pay back the amount. We have to make knowledge that it’s neither saving nor investment. It has following types:
  •  Straight Term policy
  • Convertible Term Policy
  • Decreasing Term Policy
  • Renewal Term Policy

4) Other Life Policies
Some of the types of life insurance are as follows:
  •  Single Premium Insurance
  • Joint Life Policy
  • Group Life Insurance
  • Multipurpose Insurance Policy

Types of Life Insurance

Life insurance protection comes in many forms, and not all policies are created equal, as you will soon discover. While the death benefit amounts may be the same, the costs, structure, durations, etc. vary tremendously across the types of policies. 

Whole Life
Whole life insurance provides guaranteed insurance protection for the entire life of the insured, otherwise known as permanent coverage. These policies carry a “cash value” component that grows tax deferred at a contractually guaranteed amount (usually a low interest rate) until the contract is surrendered. The premiums are usually level for the life of the insured and the death benefit is guaranteed for the insured’s lifetime. 

With whole life payments, part of your premium is applied toward the insurance portion of your policy, another part of your premium goes toward administrative expenses and the balance of your premium goes toward the investment, or cash, portion of your policy. The interest you accumulate through the investment portion of your policy is tax-free until you withdraw it (if that is allowed under the terms of your policy). Any withdrawal you make will typically be tax free up to your basis in the policy. Your basis is the amount of premiums you have paid into the policy minus any prior dividends paid or previous withdrawals. Any amounts withdrawn above your basis may be taxed as ordinary income. As you might expect, given their permanent protection, these policies tend to have a much higher initial premium than other types of life insurance. But, the cash build up in the policy can be used toward premium payments, provided cash is available. This is known as a participating whole life policy, which combines the benefits of permanent life insurance protection with a savings component, and provides the policy owner some additional payment flexibility. 

Universal Life
Universal life insurance, also known as flexible premium or adjustable life, is a variation of whole life insurance. Like whole life, it is also a permanent policy providing cash value benefits based on current interest rates. The feature that distinguishes this policy from its whole life cousin is that the premiums, cash values and level amount of protection can each be adjusted up or down during the contract term as the insured’s needs change. Cash values earn an interest rate that is set periodically by the insurance company and is generally guaranteed not to drop below a certain level. 

Variable Life
Variable life insurance is designed to combine the traditional protection and savings features of whole life insurance with the growth potential of investment funds. This type of policy is comprised of two distinct components: the general account and the separate account. The general account is the reserve or liability account of the insurance provider, and is not allocated to the individual policy. The separate account is comprised of various investment funds within the insurance company’s portfolio, such as an equity fund, a money market fund, a bond fund, or some combination of these. Because of this underlying investment feature, the value of the cash and death benefit may fluctuate, thus the name “variable life”. 

Variable Universal Life
Variable universal life insurance combines the features of universal life with variable life and gives the consumer the flexibility of adjusting premiums, death benefits and the selection of investment choices. These policies are technically classified as securities and are therefore subject to Securities and Exchange Commission (SEC) regulation and the oversight of the state insurance commissioner. Unfortunately, all the investment risk lies with the policy owner; as a result, the death benefit value may rise or fall depending on the success of the policy’s underlying investments. However, policies may provide some type of guarantee that at least a minimum death benefit will be paid to beneficiaries.

Term Life
One of the most commonly used policies is term life insurance. Term insurance can help protect your beneficiaries against financial loss resulting from your death; it pays the face amount of the policy, but only provides protection for a definite, but limited, amount of time. Term policies do not build cash values and the maximum term period is usually 30 years. Term policies are useful when there is a limited time needed for protection and when the dollars available for coverage are limited. The premiums for these types of policies are significantly lower than the costs for whole life. They also (initially) provide more insurance protection per dollar spent than any form of permanent policies. Unfortunately, the cost of premiums increases as the policy owner gets older and as the end of the specified term nears. (To learn more, read Buying Life Insurance: Term Vs. Permanent and What is term insurance?)

Term polices can have some variations, including, but not limited to:

Annual Renewable and Convertible Term: This policy provides protection for one year, but allows the insured to renew the policy for successive periods thereafter, but at higher premiums without having to furnish evidence of insurability. These policies may also be converted into whole life policies without any additional underwriting. 

Level Term: This policy has an initial guaranteed premium level for specified periods; the longer the guarantee, the greater the cost to the buyer (but usually still far more affordable than permanent policies). These policies may be renewed after the guarantee period, but the premiums do increase as the insured gets older. 

Decreasing Term: This policy has a level premium, but the amount of the death benefit decreases with time. This is often used in conjunction with mortgage debt protection.

Many term life insurance policies have major features that provide additional flexibility for the insured/policyholder. A renewability feature, perhaps the most important feature associated with term policies, guarantees that the insured can renew the policy for a limited number of years (ie. a term between 5 and 30 years) based on attained age. Convertibility provisions permit the policy owner to exchange a term contract for permanent coverage within a specific time frame without providing additional evidence of insurability.

Food for Thought
Many insurance consumers only need to replace their income until they’ve reached retirement age, have accumulated a fair amount of wealth, or their dependents are old enough to take care of themselves. When evaluating life insurance policies for you and your family, you must carefully consider the purchase of temporary versus permanent coverage. As you have just read, there are many differences in how policies may be structured and how death benefits are determined. There are also vast differences in their pricing and in the duration of life insurance protection. 

Many consumers opt to buy term insurance as a temporary risk protection and then invest the savings (the difference between the cost of term and what they would have paid for permanent coverage) into an alternative investment, such as a brokerage account, mutual fund or retirement plan.

TYPES OF LIFE INSURANCE POLICIES


You know that you need life insurance. However, with the wide variety of insurance policies available, you may find choosing the right one difficult. It’s really not as confusing as it seems, however, once you understand the basic types of life insurance policies.

Term life insurance


With a term policy, you get “pure” life insurance coverage. Term insurance provides a death benefit for only a specific period of time. If you die during the coverage period, your beneficiary (the person you named to collect the insurance proceeds) receives the death benefit (the face amount of the policy). If you live past the term period, your coverage ends, and you get nothing back.

Term insurance is available for periods ranging from 1 year to 30 years or more. You may be able to renew the policy for a new term without regard to your health, but at a higher rate. Your premium goes toward administrative expenses, company profit, and a reserve account that pays claims to those who die during the term period. As you get older, the chance that you will die increases. To cover this increasing risk, your premiums will likewise rise at regular intervals. For this reason, premiums that were quite inexpensive at the time you initially purchased your term policy will become much more expensive as you get older. Most term insurance also has a conversion feature that allows you to switch your coverage to some type of permanent insurance without answering health questions.

Traditional whole life insurance–guaranteed premiums


Whole life insurance is a type of permanent insurance or cash value insurance. Unlike term insurance, which provides coverage for a particular period of time, permanent insurance provides coverage for your entire life. When you make premium payments, you pay more than is needed to pay for the current costs of insurance coverage and expenses. The excess payment is credited to a cash value account. This cash value account allows the insurance company to charge a level, guaranteed premium* and to provide a death benefit and cash value throughout the life of the policy.

As you make payments, the cash value account grows. With traditional whole life insurance, the cash value account is guaranteed* and held in the insurance company’s general portfolio–you don’t get to choose how the cash value account is invested. However, the cash value can potentially grow beyond its guaranteed amount through the payment of dividends (profits earned by a “mutual” insurer). The cash value grows tax deferred and can either be used as collateral to borrow from the insurance company or be directly accessed through a partial or complete surrender of the policy. It is important to note, however, that a policy loan or partial surrender will reduce the policy’s death benefit, and a complete surrender will terminate coverage altogether.

If you live to the policy’s maturity date, the policy will “endow,” and the insurance company will pay the accumulated cash value (equal at maturity to the death benefit) to you.


Universal life–openness and flexibility


Universal life is another type of permanent life insurance with a death benefit and a cash value account. Like whole life insurance, the cash value is held in the insurance company’s general portfolio–you don’t get to choose how the account is invested. Unlike traditional whole life, universal life insurance allows you flexibility in making premium payments.

A universal life insurance policy will generally provide very broad premium guidelines (i.e., minimum and maximum premium payments), but within these guidelines you can choose how much and when you pay premiums. Reducing or increasing premiums will impact the growth of the cash value component and possibly the death benefit. You are also free to change the policy’s death benefit directly (again, within the limits set out by the policy) as your financial circumstances change. Be aware, however, that if you want to raise the amount of coverage, you’ll need to go through the insurability process again, probably including a new medical exam, and your premiums will increase.

Universal life policies reveal all aspects of the policy’s cost structure, including the cost of insurance (the portion set aside to pay claims) and expenses. This information is not always available with other types of policies. Another feature of universal life is the option to add the cash value to the face amount when the death benefit is paid. For example, say you die when you have $200,000 of cash value within your $1 million policy. If you chose the enhanced benefit option, your beneficiary receives $1.2 million. Keep in mind, however, that nothing is free–the increased benefit is reflected in premium calculations.


Variable life–you make the investment decisions


Like other types of permanent life insurance, variable life insurance has a cash value account. A variable life insurance policy, however, allows you to choose how your cash value account is invested. A variable life policy generally contains several investment options, known as subaccounts, that are professionally managed to pursue a stated investment objective. Choices can range from a fixed interest subaccount to a highly volatile international growth subaccount. Variable life insurance policies require a fixed annual premium for the life of the policy and may provide a minimum guaranteed death benefit*. If the cash value account exceeds a certain amount, the death benefit will increase.

Variable universal life–the ultimate in flexibility


Variable universal life combines all of the options and flexibility of universal life with the investment choices of a variable policy. It is a true hybrid product, and you make most of the policy decisions. You decide how often and how much your premium payments are to be, within guidelines. With most variable universal life policies, you get no guaranteed minimum cash value or death benefit. Your premium payments in excess of administrative costs and the cost of insurance are invested in the variable subaccounts that you choose.

As with both variable and universal life insurance, your policy may lapse if the cash value account falls below a certain level. Low-interest loans can be taken against your cash value account, and cash withdrawals are available. However, keep in mind that your policy’s face amount is reduced by the amount of a policy withdrawal, and withdrawals may be taxable. You have the option of choosing a fixed or enhanced death benefit. Today, most variable universal life policies offer a rider that guarantees the death benefit at a certain level regardless of the performance of the subaccounts, provided that a stated minimum premium is paid for a predetermined number of years*.

*Any guarantees associated with payment of death benefits, income options, or rates of return are subject to the claims-paying ability of the insurer.

Joint or survivorship life for you and your spouse


Some married couples choose to buy insurance together within the same policy. These policies take the form of either a joint first-to-die or a joint second-to-die (survivorship) design. With first-to-die, the death benefit is paid at the death of the spouse who dies first. With second-to-die, no death benefit is paid until both spouses are deceased. Second-to-die policies are commonly used in estate planning to create a pool of funds to pay estate taxes and other expenses due at the death of the second spouse. Joint and survivorship policies are generally available under any type of permanent life insurance. Other than the fact that two people are insured under one policy, the policy characteristics remain the same.

Friday, 1 May 2015

Basic Concepts of Insurance

 
 Basic Concepts of Insurance
Insurance is an economic institution that allows the transfer of financial risk from an individual to a pooled group of risks by means of a two-party contract. Insurance markets can exist because of the law of large numbers, which states that, for a series of independent and identically distributed random variables (such as automobile insurance claims), the variance of the average amount of a claim payment decreases as the number of claims increases. However, natural hazards-such as earthquakes, floods, and hurricanes—are classified as catastrophic risks. There is a high probability that many structures would be damaged or destroyed at the same time.

One way that insurers reduce the magnitude of their catastrophic losses is by employing high deductibles. The use of coinsurance, whereby the insurer pays a fraction of any loss that occurs, produces an effect similar to a deductible. Another way of limiting potential losses is for the insurer to place caps on the maximum amount of coverage on any given piece of property. An additional option is for the insurer to buy reinsurance.

Basic Concepts of Insurance

Insurance is based on the concept of risk pooling or risk sharing of losses. Basically under this concept, all individuals suffering a similar risk, place an agreed sum into a pool and the monies collected are used to indemnify any contributing individual against any loss arising out of the risk. The pool can either be managed by the individuals or paid to and managed by a company. In the former, the plan is known as mutual insurance while in the latter, the company managing the pool is known as a stock life insurance company.

For example, supposing in a certain typhoon prone community, there are 2000 houses, each worth $100000 and each is exposed to the same probability of being destroyed by a typhoon. In a particular year, if the statistics indicate that two of the houses will be destroyed by typhoon, this means that each house owner is relatively safe as he only faces a 0.1% chance that his house will be destroyed. However, should he be so unlucky as to constitute the 0.1%, his loss will be devastating. However, by setting up a common fund of $200000 to be used to compensate any two houseowners hit by typhoon, each house owner gains the assurance that any loss arising from the risk is minimised. Further, to accumulate this fund, each household only needs to contribute an affordable premium of $100. Each house owner therefore, pays a premium of $100 to buy peace of mind.

Life Quote Center is where you can get best life insurance rates. Different Life Insurance companies have different quotes. Life Quote Center provides instant term quotes for you so that you can get determine what is the best Sum Assured that you can be covered according to your budget. The website provides information about Life Insurance and to make your comparison and decision better, Life Quote Center provides financial ratings for insurers or life Insurance companies.

Human beings are exposed to different kinds of risks, Such as loss of property by fire, untimely death, and loss in accidents. They are uncertain. It is impossible to eliminate financial loss arising from an uncertain event with the help of insurance. Thus, insurance is a financial mechanism to reduce or eliminate the financial loss due to risk .However, it can neither eliminate nor reduce the risk, but only provides protection against them .Insurance is a way of sharing a risk among the peoples.

The nature of insurance can be expressed clearly by an example. Suppose there are 20,000 houses in a village each values Rs: 200000. On the basis of experience it is ascertained that four houses are destroyed by fire each year. Thus, it is clear that fire will catch in four houses next year. But, it cannot be ascertained as to which house will catch house. 

Nobody knows who those unfortunate individuals will be. One cannot foretell when and who would suffer loss. But everyone is afraid of the risk to which they are exposed. That is, everyone is likely to suffer from a loss of Rs: 200000 which is a big burden for an individual. They can find a method of providing protection against this risk by establishing a common fund to which each contributes Rs: 80 very years. The four unfortunate householders can be compensated by the created fund. It is in this cooperative measures that insurance originated. In fact, the most important from of risk transfer is insurance. 

Insurance protects a person and his dependents from loss arising from future uncertain events such as fire, flood, accidents, early death, etc. It should be remembered that the loss cannot be eliminated by insurance but it spreads over a large number of persons. The function of insurance is to distribute the loss of few persons into many persons. We have to make the idea that the insurance is a process of sharing risks.
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