Amherst Chamber of CommerceAmherst Chamber of Commerce

Frequently Asked Questions

 

 

The Amherst Chamber of Commerce has created the Frequently Asked Questions portion of Health Care Corner to answer questions that may arise when thinking about health care coverage. Below is a compilation of questions created by the Amherst Chamber. If you have any questions or want more information on Chamber health insurance, please feel free to contact Heather Hutchinson at 632-6905, or by email at hhutchinson@amherst.org.

 

 

 

What is a deductible?

A specific dollar amount your health insurance provider may require you to pay out-of-pocket each year before they begin to make payments for claims. The deductible amount varies based on the plan you choose.

 

What is coinsurance?

Coinsurance is the shared risk between you and your insurer. It is usually expressed as a percentage and indicates how you and the insurer will share the costs of a bill that exceeds your plan's deductible.

 

What is a copay?

A copay is the amount you pay out of pocket for a medical service.

 
What is a Health Savings Account?
An HSA is a tax-advantaged medical savings account that is available to those subscribers enrolled in a High Deductible Health Plan.  The account allows you to pay for eligible medical expenses which are not covered by your plan. Funds are contributed to the account by you in either a lump sum or through payroll deductions.


An HSA can fund up to $3,300 single and $6,550 family annually and there is a  20% penalty for payment to non-qualified medical services

 

My wife and I do not have any children.  Can we both enroll in a single policy and save money? Is there a 2 tier rate available?

In 2014 there is 4 tier rating. Not only can couples obtain a cheaper rate, but so can single parents.

 

What does "2.5 copays per 90 day supply of prescription drugs" mean?

Mail Order is an option you can use to save money on prescription drugs.  When you buy a 90 day  supply of a maintenance medication, you are presented with a cost savings opportunity.  Instead of paying 3 full copays for the 90 day supply, you save half a copay on the purchase. 

 

What does Out of Network mean?

Out of Network does not necessarily mean that you are receiving services outside of Western New York.  The term refers to the provider's contract with the insurance carrier.  When a provider is contracted, they agree to accept assigned reimbursements from the insurance carrier.  It is a protection to you in terms that a provider cannot overcharge you for a service.

 

I am a contracted employee and cannot get access to health insurance.  Can the Amherst Chamber help me?

If your company files a 1099 for more than one employee, you me be eligible for a group rate. Please contact Katy Murray to discuss the options that may be available to you.

 

 

Do I need to wait until my renewal to change my plan? 

There is some truth to that, in regards to Sole Proprietors enrolled in Chamber medical and dental plans.  For anyone with a small group, you can review your coverage at any time and move to a new insurance carrier if the rates and benefits fit your needs. 

 

Should I wait until I receive my renewal to begin preparing for the next plan year?

No. You can start looking at plans any time throughout the year and do not need to wait for the renewal period to make decisions.  We advise not to rush your decision and take time to weigh any changes to your benefits that might affect the premiums.

 

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