New options for small business health plans

Three major changes in federal law are rocking the boat on small business health plans. This blog posts summarizes the three most significant changes this past year.


CHANGE #1: No more individual mandate penalty in most states.

WHAT IT MEANS: Without a steep tax penalty for not having a specific type of health insurance, some people are free to consider a wider range of options. Some of these options will save money and expand choices.

WHAT FREEDOM BENEFITS IS DOING: Our financial planning conversations with clients include a wider range of options.


CHANGE #2: Expansion of short term health insurance.

WHAT IT MEANS: This adds a simple, fast, cheap coverage option for healthy people who are in life transitions.

WHAT FREEDOM BENEFITS IS DOING: Building relationships with insurance companies that offer these short term medical insurance products, reviewing specific products, expanding online enrollment


CHANGE #3: Health Reimbursement Arrangements may pay for individual insurance.

WHAT IT MEANS: Small employers are no longer persuaded to offer a group health plan. The same advantages or more

WHAT FREEDOM BENEFITS IS DOING: Emphasizing the HRA’s ability to control health costs for the employer, the ability to increase choice and value to the employee and a new tax advantage. For 2020 employee benefit plans, we include an HRA option at no additional cost in all small business benefit plans and all small business clients where we handle payroll processing.

New cost saving options for some small business health plans.

FAQs about American Health Shield dental insurance

American Health Shield Dental Insurance is no longer available but some carriers may wish to refer to the design elements.

Reproduced from the American Health Shield online quoting and enrollment Web site. Other pages about the former product were removed to prevent confusion.

What is the difference between Plan A, Plan B and the PPO Plan?

Plans A and B are traditional indemnity options which give you freedom of choice in providers and reimbursement is based upon usual and customary charges. Maximum yearly benefit is $1,250. The PPO Plan is a Preferred Provider Organization, which provides richer benefits for “in-network” based upon contracted, negotiated fees. Should you choose to go “out-of-network”, the benefits are reduced and reimbursement is based upon usual and customary charges. Maximum yearly benefit is $2,000.

How do I look up a preferred dental provider in my area?

Preferred dental providers can be found by searching here:

Who is eligible for this coverage?

This plan is offered to individuals and their spouse age 18 or older, and their unmarried dependent children (from birth to age 19 or 25 if a full-time student -subject to state requirements). All persons listed on the Application for Coverage must reside at the same home address.

When does my coverage start?

Your insurance coverage will begin on the 1st of the month (at 12:00 am), following receipt of the completed Application for Coverage form and payment of the first month plan cost.

What are my payment options?

You can pay in monthly installments by credit card (MasterCard or VISA) or Electronic Funds Transfer (EFT) from your bank.

Can I enroll my dependents?

Yes, your legal spouse, your dependent unmarried children to the end of the calendar year in which they turn 19, or your unmarried children who have not reached their 25th birthday, are allowed to enroll if the child is (1) dependent upon you for support and (2) living in your household.

How do I file a claim?

Download a Claim Form, complete it and mail to:Renaissance Dental = Payor RLHA1 P. O. Box 17250 Indianapolis, IN 46217Or, you may call our Customer Service department at Co-ordinated Benefit Plans at 866-753-1002 to request a claim form during daily business hours, 8:30 am – 5:00 pm EST Monday-Friday.

How can I check the status of my claim?

You may call Renaissance Dental Customer Service at 888-358-9484. (Please be sure to have your membership ID# available at the time of the call.)

Am I covered for all dental services?

You are covered only for the services provided under the Plan option you selected. Please refer to your Summary of Dental Plan Benefits for a complete description of the dental services provided by this Plan. Please read them carefully. For a complete listing of Exclusions and Limitations, refer to your Certificate of Coverage or master Policy.

Are these dental plans available in every state?

No, these plans of dental insurance are NOT currently available to residents of the following states:

PLAN A: AK, CO, HI, MT, NE, NV, NY, ND, VT, WA
PLAN B: AK, CO, HI, MT, NE, NV, NY, ND, VT, WA
PLAN PPO: AK, CO, CT, DE, DC, GA, HI, KY, ME, MD, MN, MT, NE, NV, NH, NJ, NY, NC, ND, OK, SD, TN, TX, UT, VT, VA, WA, WY

The PPO Plan is not available in the following counties:

Massachusetts – Dukes County, Nantucket County

Pennsylvania – Adams County, Bradford County, Cameron County, Forest County, Fulton County, Montour County, Potter County, Sullivan County, Warren County, and Wyoming County.

What is the benefit year maximum?

The benefit year maximum is the maximum amount payable for all Covered Dental Charges in any benefit year as shown in the Coverage Schedule. The Benefit Year Maximum will apply to each insured person.

Is there any kind of waiting period?

Yes, all Certificate Holders (and their Dependents, if covered above) will be eligible for coverage for Class II Benefits 6 months following the effective date of the Certificate Holder or Dependent. All Certificate Holders (and their dependents, if covered above) will be eligible for coverage for Class III Benefits 12 months following the effective date of the Certificate Holder or Dependent. All Dependents under age 19 (if covered above) will be eligible for coverage for Class IV Benefits 24 months following the date the dependent enrolled.

Is a benefit year based on a calendar year?

No, the benefit Year is based on a 12-month period beginning with the covered person’s effective date.Do these plans cover orthodontic services?Yes, the plans cover orthodontic services for dependent children to the age of 19. The 24-month waiting period applies.May I choose any dentist?Yes, you are free to choose any Dentist, as long as the Dentist is licensed to practice dentistry in the state or country in which you receive care.

Will RLHICA send payment to the Dentist, or will I receive payment?

RLHICA will either send payment to you or directly to the dentist if you have assigned benefit payments to the dentist who rendered the covered services.

What if I decide to cancel my policy?

The primary insured may cancel his or her coverage with written notice received 31 days prior to the next billing cycle. Any and all future payments will be discontinued. We will not refund any portion of payments collected before receipt of cancellation.

What are the plan’s benefits, exclusions and limitations?

The following forms are available in PDF format:

Benefits, Exclusions and Limitations for Plan A and Plan B
Benefits, Exclusions and Limitations for PPO Plan

Where can I find more information?

More information is available on the American Health Shield product page and the online quoting page. A brief profile of the Renaissance Life and Health Insurance Company of America is also available.

The most profitable New Year’s resolution: one that you can knock off in an hour

At this time of year we can read plenty of articles giving advice for the next year. The most popular articles seem to focus on how to do more, be better, and rise to new heights. Few of these articles focus on more mundane issues like saving a few minutes on daily work flow, saving taxes, or cutting business overhead expense. Yet these contribute to profitability in the same dollar-for-dollar way as other financial plans. In reality, the later type of focus on financial efficiency is more likely to to be immediately profitable to a larger number of people.

Think of your accountant as an efficiency expert. We know how to save time and money. We know what has worked best for other people like you. We start by listening to your story and challenges and then developing a checklist of possibilities for improvement. The good news is that this important first step can usually be done in an hour. Your small investment in just listing those possibilities will undoubtedly be the most profitable thing you can do to prepare for the year ahead.

Of course, everyone’s situation is unique. It is not possible to simply copy a generic ax and financial savings checklist as a formula for yourself. But you can get a jump start on saving time and money for the new year by scheduling a call or meeting to review your current situations and developing an action plan to make this the most profitable year yet.

Happy New Year!

Health insurance enrollment after the 12/15 seasonal deadline

2019 health insurance enrollment season ended 12/15/2018. That doesn’t mean that there are no coverage options.

For those who lose coverage for reasons outside their control, extended open enrollment For plans that offer full takeover of pre-existing condition coverage may be available.

Those who spend down their assets on heath care and still have insufficient income to pay for ongoing care are often eligible for Medicaid plans.

A number of limited benefit plans are available any time of year. These limit or exclude coverage for pre-existing conditions. The trade-off is that these plans are more affordable.

If you find a need for coverage outside of enrollment season, a chat with a health insurance specialist is smart place to start. OnlineNavigator offers this off-season support on request.

Freedom from Obamacare! “Great news for America!”

“ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!” – President Donald Trump, Friday December 14, 2018, commenting on his most recent court victory.

Freedom Benefits is proud to design individual and small business health benefit plans for 2019 free from the unconstitutional constraints of the Affordable Care Act in all states that do not have laws that directly compete with this new legal ruling. After Congress tried and failed to destroy the Affordable Care Act and protections for pre-existing conditions, a Texas court was successful in overturning the law in a case brought by 20 states.

If you want to implement a health plan free from Obamacare, it is important to act quickly . The IRS and insurance companies consider health plans to operate on a calendar year basis so the sooner you get started at the beginning of the year, the greater the benefit.

To get started with a no-obligation planning discussion, call or text OnlineNavigator service at (302) 404-3263 to schedule an introductory phone call.

Early 2019 health insurance enrollments are down

As of December 1, a combined total of 32 million people had enrolled for 2019 health insurance from the 39 states participating in the healthcare.gov platform. This total is down by 11 percent when compared to the same time in 2017. 

Last year over two thirds of Americans who enrolled in Obamacare plans purchased from the marketplace signed up in the last two weeks of the enrollment season. It appears to be a growing tradition for the vast majority of the sign-ups to occur close to the end of the open enrollment period.

The Kaiser Family Foundation conducted a poll from which the results showed that about 70 percent of Americans don’t know that the enrollment deadline this year is December 15. 

In general, most health insurance exchanges report that enrollments this year are lower than last year. Yet at least one enrollment firm reports that enrollments have increased this season. It appears that firms with more technologically advanced platforms hold an advantage in recruiting new health plan members. Freedom Benefits notices that access to live enrollment support at the point of enrollment, either by telephone or online, also has a positive impact on enrollments.

Enrollment for the supplemental and alternate plans listed on FreedomBenefits.net remains open year-round. Some but not all of thee plans  are available ithout regard to serious medical history. None of these plans provides the same level of coverage for pre-existing medical conditions as the plans from the government’s Health Insurance Marketplace.

The real small business health benefit

Your employees already have health insurance. Chances are they found coverage though the Health Insurance Marketplace with a premium subsidy that gives then a lower net cost than anything your business could provide.

But the benefits are lacking. The large deductible leaves them scared. Nobody has an extra $5,000 or more just sitting around in case of an accident or illness! And what about lost wages during time off from work? What can you do to help?

The employer can offer inexpensive supplemental gap insurance that pays cash benefits in addition to the primary insurance. The cost can be as little as $20 per month. And because it is provided through an insurance plan, your employee does not risk losing their premium subsidy.

Check out Smart Insurance Marketplace to learn more. Live help is available by phone and email.

health benefits

Low cost health insurance expands

President Trump signing
President Trump authorized new health plan options

The market for lower cost affordable health insurance is expected to grow with at least to more companies making public securities market offerings for expansion. Bright Health and Oscar Health both completed successful public offerings this year.  These health plans offer lower beenfits at a lower cost in states that allow these alternatives. President Trump pushed for approval of these plans that were previously prohibited by Obamacare. Not all plans are available in all states.

Freedom Benefits has served as a leading adviser in this field since 1995. We support freedom of choice for well-informed consumers and we will continue to monitor, review and recommend these alternative health plans as they develop. Personal support is available online or by telephone.

Celebrating a small mile mark for Freedom Benefits

Today we are celebrating a small mile mark for Freedom Benefits with the enrollment assistance provided to the first “new generation” health plan applicant for 2019. I thought this would be a good time to summarize the history of the project and how we came to this point:

cropped-american-eagle1-1.jpg1995 – Freedom Benefits is launched in Pennsylvania as a way to help local building contractors find health insurance using online technology so that insurance agents dd not have to bother with this mundane work.  The logo photo of an American bald eagle with the American flag was taken while visiting an outdoors expo in Oaks PA with my young son.

1997 – The concept “gels” and Freedom Benefits comes to stand for freedom of choice for consumers; a concept that works only if consumers have access to fair, unbiased and accurate advice. The service quickly expanded nationwide offering low cost and alternative  kinds of health insurance. Tony was one of the few people in the US licensed in all 50 states and DC and was conversant in all states’ health insurance laws, consumer issues and planning.

1998 –  our web site Medsave.com was the fastest growing in the industry even brefly outpacing the growth rate of Ehealthinsurance.com. (Then Ehealth went public and exploded in growth leaving us in the dust).

2003 – Tony made national news a few times as an expert on Medical Savings Accounts and the new Health Savings Accounts.

2004 – Passed 50,000 users. Received an offer to sell at $1.6 million and declined it as too low based on the rate of growth.

2009 – Medsave.com was sold at a fraction of the earlier offer because of the threat of the Affordable Care Act disrupting the market.

2010 – The Affordable Care Act is passed and Freedom Benefits grinds to a halt.

2013 – FBI investigates Pennsylvania scammers using the business name that caused us grief for a while. We were cleared as not being related to the scammers trying to steal identity.

2012 – Applied for trademarks for “Freedom Benefits”, “OnlineAdviser” and “OnlineNavigator” in hope that the post-Obamacare industry would elvolve in a way where we could participate.  Freedom Benefits focused primarily on Health Reimbursement Arrangements for small businesses just to keep active.

2015 – Made an arrangement with SASID to handle enrollment while Tony handled online user support, primarily offering pre-enrollment health care planning.

October 2018 – Trump administration authorizes the expansion of alternate health insurance.

November 2018 – Freedombenefits.net web site relaunches with a new marketing plan.

Today, November 26, 2018 the new web site assisted in the enrollment of the first person on a new alternative type of post-Obamacare health insurance plan.


(The earlier dates in this blog post are approximate based on memory).

20 states fight unconstitutional Obamacare provisions

President Trump signing

Twenty states sued the federal government in February 2018 arguing that the current law requiring insurance companies to cover pre-existing conditions is unconstitutional. The US Justice Department now sides with these 20 states in trying to use the courts to bring an end to Obamacare. Led by Texas Attorney General Ken Paxton and Wisconsin Attorney General Brad Schimel, the lawsuit said that without the individual mandate, which was eliminated as part of the Republican tax law signed by President Donald Trump in December, Obamacare was unlawful. Ironically, observers say that these 20 states stand to lose more health care funding than many other states if the lawsuit is successful. A copy of the initial filing is available here.

Paxton said “The U.S. Supreme Court already admitted that an individual mandate without a tax penalty is unconstitutional. With no remaining legitimate basis for the law, it is time that Americans are finally free from the stranglehold of Obamacare, once and for all”.

Alabama Attorney General Steve Marshall, representing one of the other twenty states in the lawsuit argues a provision in the Affordable Care Act requiring insurers to cover pre-existing conditions is unconstitutional. The lawsuit would affect almost one million people in Alabama alone according to the Kaiser Family Foundation, a non-profit with insurance industry connections. They say that about 1 in 3 people in the state of Alabama have a pre-existing medical condition that would not be covered if the state’s lawsuit is successful.

To address this situation, President Donald Trump issued an executive order early in his presidency directing the adoption of regulations that would deem some low-cost health insurance that does not cover pre-existing conditions as being ACA-compliant.

The 20 states that want to end Obamacare are: TEXASWISCONSINALABAMAARKANSAS, ARIZONA, FLORIDAGEORGIA, INDIANAKANSASLOUISIANA, MAINEMISSISSIPPIMISSOURINEBRASKANORTH DAKOTASOUTH CAROLINASOUTH DAKOTATENNESSEEUTAH, and WEST VIRGINIA.

Freedom Benefits stepped up its services to offer advice on choosing between the old and new types of health care plans and can help introduce consumers to the best health plan for their situation and budget. Freedom Benefits reminds residents of these 20 states that a medical condition that makes a person uninsurable can happen to anyone at any time. It is important to have a backup plan and an asset protection plan to protect family assets from the high cost of unexpected and uninsured medical costs.