Frequently Asked Questions

Auto / Home / Life

Group Medical Benefits

Medicare Services

Commercial & Business Liability

Health Insurance

Auto / Home / Life

• • What is Whole Life Insurance?

    Once you are approved, this is guaranteed life insurance protection that will not decrease. There is also guaranteed cash value that builds over time that can be borrowed to take advantage of future opportunities that. Lastly, you will have a guaranteed premium that does not change, regardless of changes in your health.

  • What is Term Life Insurance?

    Term life insurance is a popular form of coverage that allows you to purchase large amounts of protection at attractive premium rates. Term insurance is ideal for protecting a mortgage, providing replacement income or funding college for a child in the event of a premature death.

  • What is an umbrella policy?

    An umbrella policy provides an extra layer of liability protection and would be purchased in addition to your homeowner’s policy. With lawsuits always on the rise, all homeowners should consider umbrella protection. If someone gets injured on your property, you could be held liable by a court for damages. Your liability coverage through your homeowner’s policy would pay for those damages but only up to a certain amount. In the event of a lawsuit, your umbrella coverage would kick in after your homeowner’s coverage reaches its limitations.

  • Is Renter’s Insurance the same thing as Homeowner’s Insurance?

    No, the biggest difference between rental and homeowner’s insurance is the dwelling coverage. When you own the home, you need insurance to cover the cost of replacing your home if it is lost in a fire, repairing the home if it is damaged by vandalism, fire, or water, and to protect you from other structural concerns (like a tree falling on the roof and caving it in).

    When you are a renter, you need to insure yourself against damage you might cause to the rental property and insurance for your own personal property. For example, if you have a waterbed and it breaks and damages the flooring, your insurance could cover that if it is included in your policy. However, if there was massive rain that caused flooding to the building, your landlord’s insurance policy would cover the damage. It would not be the renter’s responsibility. Your renter’s policy should focus more on replacing your personal property that might be stolen, damaged, or lost in a fire or flood. Your landlord’s policy is responsible for injuries that happen on the premises and damage to the property itself.

    Both rental and homeowner insurance provide protection for you and your property. Both insurances are designed to help you replace lost personal property as a result of fire or water damage, vandalism and theft. In addition, both rental and homeowner insurance can provide you with liability protection in case someone is injured while at your home. However, if someone is injured while at your rental property, the landlord may be liable regardless of the cause of the injury.

  • What are state minimums for Ohio and how do they work with regards to auto insurance?

    State minimum(s) are the auto insurance requirements that each state mandates by law for their licensed residents. Typically, the state minimum is not recommended because it often leaves you exposed and liable for expenses beyond the coverage limit in the case of an auto accident. The current state minimums for Ohio are: Bodily Injury Liability: $12,500 limit per individual/$25,000 limit per occurrence, Property Damage Liability: $7,500 Limit per occurrence. As you can see, in the case of an auto accident, the most your insurance company would pay to the other party is $12,500 per person, $25,000 total (regardless of how many people were injured) and only $7,500 to repair any damages. All additional costs would be your responsibility.

  • What factors influence my premium?

    Some of the factors underwriters consider in calculating your insurance premium are prior loss history and risk assessment. They consider the risk the company is assuming compared to the premium you are paying for your policy.

  • What is Property and Casualty Insurance?

    Property insurance covers damages to or loss of property, including homes, autos or luxury items such as jewelry or computers. Casualty insurance is purchased to cover legal expenses incurred from bodily injury or property damage to someone else. Property and casualty insurance is subdivided into two major lines: personal and commercial.

  • What is Universal Life Insurance?

    Universal life insurance provides financial security for your family or business by combining the best features of term and permanent life insurance. It includes life insurance protection with an account value that earns tax-deferred interest. It can also be adjusted to meet your changing needs. Choose the amount of protection you want and design a premium schedule to match your budget.

Commercial & Business Liability

• • How do Bonds Work?

    Bonds are a type of “guarantee” that business owners can purchase to back up their workmanship. Bonds give the clients of a business reassurance that they will receive sufficient services and if they do not, they will be repaid any money that they paid out. It’s a three-party agreement where the third party (insurance company) guarantees to a second party (obligee or owner) the successful performance of the first party (business owner). Bonds are not a true form of insurance with the distinction that they must be paid back. A bond is not an insurance policy. An insurance policy assumes that there will be a loss, so the premium for an insurance policy is calculated to cover losses that will occur. A bond, on the other hand, is an extension of credit with the assumption that the legal obligation will be fulfilled, and consequently, there will be no loss. The bond premium paid to the surety covers only the underwriting expenses of the surety company. When losses occur, they have a significant impact on the surety company’s financial results.

  • What is a Commercial Policy?

    A Commercial policy is one that protects commercial property owners and landlords. These policies are designed to protect your property, income protection and liability needs.

  • What is a Business Owner’s Policy? (BOP)

    A business owner’s policy (BOP) has been compared to a homeowner’s policy for business. BOPs were first developed in the 1970s and have become a very popular form of insurance for small to medium sized businesses. BOPs combine some of the basic coverage needed by a typical small business into a standard package at a premium that is generally less than would be required to purchase these coverages separately. A BOP includes coverage for your property, income protection and liability needs.

  • What Is Key Person Insurance?

    Key person insurance is generally a term life insurance policy, with the length term being the time until that employee retires. The company pays the premiums on the policy and receives the death benefits if the employee unexpectedly dies. If the employee retires, the company may choose to also surrender the insurance contract, giving the employee the chance to convert the policy to a permanent one. Key man insurance is meant to cover the company’s losses in the event of the death of a key employee. That employee may be a particularly capable sales person, a manager, or the company owner, the underlying assumption is that the company will suffer greatly should that person pass away.

Group Medical Benefits

• • What is a negotiated rate?

    A negotiated rate is the amount participating providers (doctors, hospitals) agree to accept as payment in full for covered services. It is usually lower than their normal charge.

  • What is a Health Savings Account (HSA)?

    A Health Savings Account, or HAS, combines high deductible health insurance with a tax-favored savings account. Money in the savings account helps pay the deductible. Once the deductible is met, the insurance starts paying. Money left in the savings account earns interest and is yours to keep.

  • What is the difference between co-insurance and a co-pay?

    A co-insurance is the amount that you may be required to pay for covered medical services after you have satisfied any plan deductible. A coinsurance is typically expressed as a percentage. A common co-insurance split is 80/20. This means that the insurance company will pay 80% of the procedure and the insured is required to pay the other 20%. A co-pay is a fixed amount that the insured is required to pay at the time of service. It is usually required for basic doctor visits and when purchasing prescription medications.

  • What is a deductible?

    The deductible refers to the amount of money that the insured would need to pay before any benefits from the health insurance policy can be used. This is usually a yearly amount so when the policy starts again, usually after a year, the deductible would be in effect again. Usually there are separate individual deductible amounts and total family deductible amounts.

  • Can I be denied for coverage on a group plan based on my medical history?

    No. A group health plan may not establish eligibility for enrollment based on an individual’s or a dependent’s health status, physical or mental medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, or disability.

  • What is a Health Reimbursement Arrangement (HRA)?

    A Health Reimbursement Arrangement (HRA) is an employer-funded medical reimbursement plan. The employer sets aside a specific amount of pre-tax dollars for employees to pay for health care expenses on an annual basis. Based on the plan design, HRAs can generate significant savings in overall health benefits.

  • What is a PPO?

    A preferred provider organization or a PPO, is a health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee. PPOs may also offer more flexibility by allowing for visits to out-of-network professionals, but at a greater expense to the policy holder. Visits within the network require only the payment of a small fee. There is often a deductible for out-of-network expenses and a higher co-payment.

  • What is a HMO?

    Health Maintenance Organizations or HMO’s are managed care plans that provide care for enrollees by contracting with specific health care providers to provide specified benefits. Many HMO’s require enrollees to see a primary care physician (PCP) chosen by the member who will refer them to a specialist if deemed necessary. HMO plans often do not include deductibles, but co-pays are charged per office and any visit to a provider out of the HMO network is not covered and the patient is responsible for the total cost of the visit. HMO plans typically allow a member to have lower out-of-pocket healthcare costs, but require the member to forego some choice and flexibility with regard to selecting physicians and hospitals.

  • What is a negotiated rate?

    A negotiated rate is the amount participating providers (doctors, hospitals) agree to accept as payment in full for covered services. It is usually lower than their normal charge.

Health Insurance

• • What is the difference between co-insurance and a co-pay?

    A co-insurance is the amount that you may be required to pay for covered medical services after you have satisfied any plan deductible. A coinsurance is typically expressed as a percentage. A common co-insurance split is 80/20. This means that the insurance company will pay 80% of the procedure and the insured is required to pay the other 20%. A co-pay is a fixed amount that the insured is required to pay at the time of service. It is usually required for basic doctor visits and when purchasing prescription medications.

  • What is a PPO?

    A preferred provider organization or a PPO, is a health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee. PPOs may also offer more flexibility by allowing for visits to out-of-network professionals, but at a greater expense to the policy holder. Visits within the network require only the payment of a small fee. There is often a deductible for out-of-network expenses and a higher co-payment.

  • What is a HMO?

    Health Maintenance Organizations or HMO’s are managed care plans that provide care for enrollees by contracting with specific health care providers to provide specified benefits. Many HMO’s require enrollees to see a primary care physician (PCP) chosen by the member who will refer them to a specialist if deemed necessary. HMO plans often do not include deductibles, but co-pays are charged per office and any visit to a provider out of the HMO network is not covered and the patient is responsible for the total cost of the visit. HMO plans typically allow a member to have lower out-of-pocket healthcare costs, but require the member to forego some choice and flexibility with regard to selecting physicians and hospitals.

  • What is a Health Savings Account (HSA)?

    A Health Savings Account, or HAS, combines high deductible health insurance with a tax-favored savings account. Money in the savings account helps pay the deductible. Once the deductible is met, the insurance starts paying. Money left in the savings account earns interest and is yours to keep.

  • What is a negotiated rate?

    A negotiated rate is the amount participating providers (doctors, hospitals) agree to accept as payment in full for covered services. It is usually lower than their normal charge.

  • What is a deductible?

    The deductible refers to the amount of money that the insured would need to pay before any benefits from the health insurance policy can be used. This is usually a yearly amount so when the policy starts again, usually after a year, the deductible would be in effect again. Usually there are separate individual deductible amounts and total family deductible amounts.

  • How does gender, age and tobacco use affect my rate?

    The older you are the higher the cost of the policy. Gender has less impact except if there is maternity coverage. And finally tobacco use may increase the cost of the policy up to 35% for certain insurers.

  • What is an exclusion or pre-existing condition?

    An insurance underwriter may accept an application but exclude coverage for “preexisting conditions.” For example, you may have had recent knee surgery and the insurance carrier will accept your application excluding all claims related to your injured knee. Such exclusions may last for a specific period of time or the life of the policy.

Medicare Services

• What does AEP mean?

  AEP stands for Annual Election Period and it runs from November 15 until December 31. This is when a Medicare beneficiary can enroll into a Medicare Part D plan, re-enroll into their existing Medicare Part D Plan or change into another Medicare Part D plan. Beneficiaries can also switch to a Medicare Advantage Plan that also has a Prescription Drug plan. The chosen Medicare Part D plan coverage begins on January 1st.

• What is Medicare Part D?

  Part D is prescription drug coverage offered though private companies. In order to apply for Part D, you must also be enrolled in Parts A and/or B. To apply for Part D coverage, you must enroll by calling 1-800-MEDICARE or by going to the carrier’s website. If you are enrolled in a Medicare Advantage plan, you most likely have Part D coverage included. If you do not, then you may apply for Part D coverage separately, but must also be enrolled in Medicare Parts A AND B.

• What is a Medicare Advantage plan?

  Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are health plans offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, the plan provides all your Part A and Part B coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most plans also include Medicare prescription drug coverage. You usually pay a monthly premium to the Medicare Advantage plan, in addition to your Part B premium.

• What is Medicare Part A and B?

  Part A is hospital insurance provided by Medicare. Most people do not pay a premium for this coverage. Part A covers inpatient care in skilled nursing facilities, critical access hospitals, and hospitals. Hospice and home health care are also covered by Part A. Part B is medical insurance to pay for medically necessary services and supplies provided by Medicare. Most people will have to pay a premium to receive this coverage. Part B covers outpatient care, doctor’s services, physical or occupational therapists, and additional home health care.

• I am turning 65 and am eligible for Medicare. What do I need to do?

  You will automatically be enrolled in Medicare Part A the month you turn 65. If you do not already receive social security benefits, you will need to apply for Part B. You can do so by either visiting your local social security office, by calling social security at 1-800-772-1213 or by applying online at www.socialsecurity.gov. To ensure there is no delays for your Part B start date, you may apply for coverage 3 months prior to the month you turn 65.