Ndalama ya inshuwalansi ya zaumoyo ndi malipiro a mwezi uliwonse omwe amaperekedwa kwa kampani ya inshuwaransi kapena ndondomeko yaumoyo kuti apereke chithandizo chamankhwala. Kupereka chithandizo cha zaumoyo kumaphatikizapo zonse kapena gawo limodzi la ndalama zothandizira zokhudzana ndi umoyo monga dokotala, maulendo, zipatala, ndi mankhwala.
Mwachidule, malipiro omwe mumapereka kwa kampani yanu ya inshuwalansi yaumphawi yomwe imapereka chithandizo chonse.
Malipiro oyambirira ali ndi tsiku loyenerera kuphatikizapo nthawi yabwino. Ngati phindu sililipidwa mokwanira kumapeto kwa chisomo, kampani ya inshuwalansi ya umoyo ikhoza kuyimitsa kapena kuletsa kufalikira.
Ndalama zina za inshuwalansi zaumphawi zingaphatikizepo ndalama zowonongeka , zothandizira ndalama , ndi zolipira . Izi ndizo ndalama zomwe mumalipira mukafuna chithandizo chamankhwala. Ngati simukusowa mankhwala alionse, simudzalipira deductible, copays, kapena coinsurance. Koma mumayenera kulipira malipiro anu mwezi uliwonse, mosasamala kanthu kuti mumagwiritsa ntchito inshuwalansi yanu kapena ayi.
Ndani Amapereka Pulezidenti Wa Inshuwalansi Zaumoyo?
Ngati mutalandira chithandizo chaumoyo kudzera muntchito yanu, abwana anu amapereka malipiro ena kapena mwezi uliwonse. Kawirikawiri, kampani yanu idzafuna kuti muthe kulipira gawo lina la mwezi uliwonse, womwe udzachotsedwe pamalipiro anu. Zidzatha kuphimba zonsezi.
Kafukufuku amene bungwe la Kaiser Family Foundation la 2016 linalemba, abwana amapereka pafupifupi 82 peresenti ya malipiro onse ogwira ntchito osakwatira, ndipo pafupifupi 71 peresenti ya ndalama zapakhomo za banja, kwa antchito omwe amawonjezera mamembala awo ku ndondomeko.
Ngati muli odzigwira okha kapena kugula inshuwalansi ya umoyo wanu, inu nokha muli ndi udindo wolipirira mwezi uliwonse mwezi uliwonse. Komabe kuyambira chaka cha 2014, Affordable Care Act wapereka ndalama zothandizira msonkho (zopereka zothandizira) zomwe zimapezeka kwa anthu omwe amagula malonda awo pogwiritsa ntchito kusinthanitsa .
Kuti muyenerere ndalama zowonjezera ndalama zanu, ndalama zanu sizingapitilire 400 peresenti ya umphaŵi wa federal, ndipo simungathe kupeza chithandizo chokwera mtengo, kuchokera kwa abwana anu kapena abwana anu.
Ndondomeko zotsatsa malonda zogulidwa kuyambira 2014 zikugwirizana ndi ACA, koma ndalama zothandizira ndalama sizingagwiritsidwe ntchito kuthetsa mtengo wawo. Izi zingasinthe, komabe, ngati American Health Care Act yakhazikitsidwa .
Chitsanzo cha Pulezidenti
Tiyerekeze kuti mwakhala mukufufuza kafukufuku wa zaumoyo ndi ndondomeko kuti mupeze ndondomeko yotsika mtengo komanso yoyenera kwa inu ndi okondedwa anu. Pambuyo pa kafukufuku wochuluka, pamapeto pake mumatha kusankha ndondomeko inayake yomwe imadula $ 200 pamwezi. Malipiro a $ 200 a mwezi uliwonse ndi wanu inshuwalansi premium. Kuti chisamaliro chanu chonse chithandizo chikhale chopindulitsa, premium ya inshuwalansi ya umoyo imayenera kulipira mokwanira mwezi uliwonse.
Ngati mukulipirira nokha, bili yanu ya mwezi idzabwera mwachindunji kwa inu. Ngati bwana wanu amapereka ndondomeko ya inshuwalansi ya gulu, ndalamazo zidzalipiridwa ndi ndondomeko ya inshuwaransi ndi abwana anu (kapena abwana ndi omwe ali ndi inshuwalansi, omwe ali makamaka kwa antchito akuluakulu), ngakhale kuti gawo limodzi la ndalama zonse Zingatheke kusonkhanitsidwa kuchokera kwa wogwira ntchito aliyense kudzera podula malipiro.
Ngati muli ndi ndondomeko yaumoyo yaumwini kudzera mu kusinthanitsa ndipo mukulandira ndalama zothandizira, ndalamazo zidzaperekedwa ndi boma, molunjika kwa kampani yanu ya inshuwalansi. Ndalama yotsalayo ya msonkhanowu idzaperekedwa kwa inu, ndipo mudzayenera kulipira gawo lanu kuti mupitirize kugwira ntchito yanu. Mwinanso, mukhoza kusankha kulipira malipiro anu enieni mwezi uliwonse ndikudandaula kuti msonkho wanu wamtengo wapatali umabwereranso kumapeto kwa kasupe (izi sizodziwika, koma zimapezeka ndipo zosankha zanu ndi zanu).
Zowonongeka, Copays, ndi Coinsurance
Ndalama zimayikidwa ndalama zomwe ziyenera kulipidwa mwezi uliwonse.
Ngati malipiro anu ali pafupi, ndinu inshuwalansi. Mfundo yakuti ndinu inshuwalansi, sizitanthawuza kuti ndalama zanu zonse zothandizira zaumoyo zimaperekedwa.
Zopindulitsa . Zokhumudwitsa, malinga ndi Healthcare.gov, ndi "ndalama zomwe mumalipiritsa pazinthu zothandizira zaumoyo musanayambe kukwaniritsa inshuwalansi yanu. Mwachiwongoladzanja ndalama zokwana $ 2,000, mwachitsanzo, mumalipira ndalama zokwana $ 2,000 zokhazokha. , nthawi zambiri mumalipiritsa ndalama kapena ndalama zokhazokha pazinthu zophimbidwa. " Kulipira ndalama zowonjezera nthawi zambiri kumagwirizanitsidwa kwambiri ndi anthu omwe amawotcherapo: Mudzabwezera zambiri pa inshuwalansi yomwe imakhala yochepa kwambiri, komanso mosiyana (zindikirani kuti ndondomeko za ACA zogwirizana nazo, kuphatikizapo ndondomeko zomwe zimagwiritsidwa ntchito ndi ogwira ntchito komanso malonda omwe akugulitsidwa, zimakhudzana ndi ntchito zina zoteteza ku palibe mtengo kwa olembetsa, ngakhale ngati deductible siinakwaniritsidwe).
Malipiro olipira . Ngakhale inshuwalansi ya umoyo wanu ili ndi ndalama zochepa kapena zopanda malipiro, mwina mudzafunsidwa kupereka malipiro ochepa kwambiri kuchipatala. Malipiro awa amatchedwa "kubwerekanso." Zolinga zambiri zimaphatikizapo ndalama zothandizira ndi ndalama zothandizira, pamodzi ndi malipiro omwe amagwiritsidwa ntchito kuntchito monga maulendo apadera ndi zolembera, pamene ndalama zimagwiritsidwa ntchito kuchipatala, ntchito ya labu, opaleshoni, etc. .
Coinsurance. Healthcare.gov imalongosola motsimikiza kuti: "Kuchuluka kwa ndalama za ntchito yothandizira odwala (20% mwachitsanzo) mutatha kulipira ndalama zanu. ndalama zanu ndi 20%. Ngati mwalandira ndalama zanu: Mumalipira 20% ya $ 100, kapena $ 20. "
Zowonongeka, ndalama zothandizira, komanso ndalama zothandizira ndalama zimagwiritsidwa ntchito pafupipafupi chaka chonse cha wodwalayo. Pakati pa ndalama zapakati pa chaka chonse ndizopambana kapena kampani yonse ya inshuwalansi imafuna kuti wodwalayo azilipira yekha pa mtengo wake wonse wa chisamaliro chawo.
Pokhapokha ngati wodwalayo atapatsidwa ndalama, ndalama zothandizira ndalama, komanso ndalama zothandizira ndalama kwa chaka chimodzi zimaphatikizapo ndalama zowonjezereka, zomwe wodwalayo akugawana nazozo zimatha kumapeto kwa chaka chomwecho. Pambuyo pokwaniritsa kukwera kwa mthumba, dongosolo la thanzi likutenga ndalama zonse zowonongeka pa intaneti kwa chaka chotsalira. Komabe, malipiro ayenera kupitilizidwa kulipira, mwezi uliwonse, kuti apitirize kufalitsa.
> Zotsatira:
> Kaiser Family Foundation, 2016 Employer Health Benefits Survey. September 14, 2016.