Without fail, I always receive questions and concerns about plan deductibles. Most believe that you must satisfy the entire deductible before any services are covered. Let’s put that myth to bed. The annual deductible applies only to the services billed until the deductible is met. The member is only paying the contracted price for that […]
Benefits are complicated and getting more so. Unfortunately, benefits education has often been reduced to a one-hour open enrollment meeting a year. Since benefits are one of the top three investments or line items (depending on how you look at it), doesn’t it merit more attention? Spending the time to fully educate yourself on your […]
Having treatments or claims denied by the insurance company happens far too often. Some people try to fight it on their own, which can seem like an endless battle, while others who are more fortunate tend to pay for the treatment out of pocket and figure it out later. There is a third option, which […]
Over the years, we all have our customer situations that stand out, and we remember. As my first client with Sapoznik Insurance, a World Company, and a referral from a partner agency, this one was particularly memorable. One of the things that attracted me to this organization is its dedication to its clients year-round. In […]
Can I appeal a health insurance claim if I was treated at an in-network hospital but the physicians were not? Yes you can, and you should.
If you are stuck on selecting a health plan, Benefits Consultant and Benefits Educator Ileana Miranda reviews what to look for and what to ask when it comes to your employer-sponsored health plan.
In recent years, Florida, specifically Miami, has attracted attention as a global hub for business. From the Mayor of Miami, Francis Suarez, making a hard and successful push to be the next Silicon Valley to the new law signed by the governor, gone are the days where people believe Florida is just a place to […]
Even for this health insurance maven, dealing with health insurance claims is a nightmare. On Saturday, April 17th, 2021, I woke up feeling sick. I had hoped I would get better, instead as the day progressed, I fell violently ill. I finally called Miami-Dade Rescue. I thought that my time had come! I was so […]
Ever wonder how many Americans have group health insurance? The Kaiser Family Foundation estimates that approximately 156,199,800 Americans (49 percent) receive employer-sponsored health insurance (also known as group health insurance). You may have one question in mind regarding employers providing coverage for their employees and their dependents: Why? Because it’s good for their teams and good for business. […]
Association memberships are a vital part of my social life. Some may see this as challenging the “work-life balance,” I see it differently. Aren’t friendships developed by common interests and like-minded people? Aren’t associations formed for the same thing? I belong to the Florida Restaurant and Lodging Association, Florida Association of Non-Profits, and several large Chambers of Commerce, which speaks to my different interests both personally and professionally. Beyond making acquaintances […]
Suppose you are one of the fortunate individuals that will receive a retirement package that includes continued health coverage from your company. In that case, it will more than likely come in the form of a Medicare Supplement or a Group Medicare Plan. The question is, will it meet your retirement needs? My clients often ask to meet when preparing for retirement. They call to learn of their options in transitioning to a Medicare Plan and how it works. Unbeknownst to […]
I started in the insurance industry totally by accident while going through a life- changing event! When I had my children, I decided to be a stay-at-home mom, and left the workforce. It was a wonderful six years until my divorce forced me to go back to work. I had to face reality. I had no relevant work experience. I was lost. I needed flexibility with […]
Retaliation claims are the most frequently filed charge of discrimination—making up more than 48 percent of all charges filed in 2017. The number of retaliation lawsuits may continue to rise due to new regulations proposed by the EEOC. Discrimination lawsuits can be very time-consuming and expensive for employers and can result in a loss of employee morale or reputation within the community.
The deductible and out-of-pocket maximum for your healthcare plan reset every year on January 1. This is especially important to highlight because many people have completed their open enrollment for the new year by now. And if you are like most people, you try to get through it as fast as possible without understanding the […]
This is Close to My Heart As COVID 19 continues to take up space in almost every conversation, other health issues are still present. Among women, heart disease is the leading cause of death. According to the Centers for Disease Control and Prevention (CDC), it kills about 1 in 5 women a year. My family […]
In the past, my weight has been mostly inspired by a need to change my physical appearance. Now that I am in my mid-40’s it’s all about health since I’m already starting to see health issues pop up related to the weight gain that I will address in future posts.
Does your hotel have the coverage it needs? Are your hotels and employees protected? Hotels are exposed to various risks because they have large properties, serve numerous guests and often employ a large staff. Does your hotel have a blind spot in its coverage? If you run a hotel, you’ll likely need insurance that covers […]
Ban on Surprise Medical Bills President Trump signed the Consolidated Appropriations Act, 2021, into law on December 27, 2020. It includes a $900 billion coronavirus relief package that provides funding for: – Unemployment benefits – Direct economic payments to individuals – Vaccine distribution – Rental assistance – No Surprises Act, beginning in 2022. […]
Congress passed an emergency stimulus package that delivers roughly $900 billion in COVID-19-related aid on December 21, 2020, and on December 27, 2020, President Trump signed the bill into law. The bill was part of a $1.4 trillion spending package that will keep the government afloat for the fiscal year. Continue reading to gain a […]
Dear 2020, I have no doubt as to your historical significance. It has been a year that no one will ever forget or want to go through again. I never imagined that as I was having dinner with my family at Truluck’s on New Year’s eve, celebrating the upcoming new decade with great hope and […]
My birthday is usually my favorite day of the whole year. I love planning parties and bringing my closest friends and family together for a happy occasion. But on this upcoming birthday, there was only one thing on my mind: my health insurance. I was about to turn 26, and I was full of panic […]
A lot of people don’t give much consideration to certain workplace benefits like long term care insurance or consider life insurance policies beyond what their jobs offer. The older I get, the more I look back and have a better appreciation for those who raised me and the struggles they faced. I’m currently only a […]
COVID-19 has brought many changes to our lives and has forced us to spend more time by ourselves, and learn more about who we are. Our CEO, Rachel Sapoznik, decided that there was no time like the present to cross another item off her bucket list. Rachel has always wanted to road trip through the USA. It just took a pandemic to give her the nudge she needed.
I recently found out that one in five people have mental health conditions. As the number of COVID-19 cases increase, so does the associated anxiety. Mental health was never really top of mind for me. I have always been a happy, social, and positive person. So, like anything else in life, if it doesn’t apply […]
The entertainment giant Regal Cinemas was brought to a grinding halt as new standards have been mandated for how we live daily life. The changes we hope are temporary, but so many of them inevitable. This past Sunday, Michael (my husband) and I were running our usual weekend errands in preparation for the week ahead. […]
It feels incredibly easy to focus on ourselves during this pandemic. Our own families, our children, our grandchildren, our individual health. Especially when the virus is very much still here – and on the rise – in Florida. The immediate reaction for many is panic, and correspondingly, protect. Protect your own. But I implore us […]
Unmasked, why? That’s the question I ask myself every time I see someone walking around without a mask. I think that there are a few reasons why people aren’t wearing them. Some believe that they aren’t sick so why wear one; others say that it is hard to breathe and they are uncomfortable; and unfortunately, some are just unmoved and don’t realize the importance of wearing one.
Rachel Sapoznik, Founder, CEO & President of Sapoznik Insurance, has emerged as a prominent and incredibly important voice during the #COVID19 outbreak. As a healthcare insurance expert—as well as a business owner and landlord—Rachel sits at a unique crossroads of expertise and has provided the press— and our citizens — with unparalleled information regarding how to best navigate this crisis from many angles.
Employee Spotlight: Christine Nunzio Christine is a Senior Account Manager at Sapoznik Insurance and will be celebrating 11 years with the company this April. After a brief medical leave, Christine is back full force with the same driving passion to help others that she’s had all along. We sat down with Christine to hear about […]
According to the Health Research & Individual Trust (HRET), health insurance premiums rose 3% for single coverage, and 5% for family coverage in 2018, with the average worker contribution toward the premium being 18% for single coverage and 29% for family coverage.
Effective Jan. 1, 2019, the EEOC removed the incentive limits from its final wellness plan rules under the ADA and GINA to implement a court’s order that vacated that portion of the final rules.
On Dec. 14, 2018, a federal judge ruled in Texas v. United States that the entire Affordable Care Act (ACA) is invalid due to the elimination of the individual mandate penalty in 2019. The Department of Health and Human Services (HHS) also confirmed that it will continue administering and enforcing all aspects of the ACA.
Seasonal affective disorder (SAD) is like any other condition. It doesn’t make you a weak person because you suffer from it. And like any disorder, it can be treated, and prevented, if proper measures are taken. Here’s what you need to know.
Visiting the doctor gave me the wakeup call that I needed. I had just turned 60 years old and went for my annual check-up. Everything seemed normal until the doctor prescribed cholesterol medicine. My heart sank. Never in my life did I have cholesterol issues, but on my 60th birthday, this changed. Happy birthday to me!
A disaster preparedness plan is something you hope you never use but, proper planning can give you the peace of mind that comes with knowing that your business is ready, willing, and able to shift into disaster response mode, if necessary.
Choosing the right healthcare coverage is difficult and often seems like a one-size-fits-all package: expensive coverage with options you may not need. Your company’s line of business and employee demographics are the basis for designing insurance plans. Whether you’re a car dealership, tech startup, non-profit or call center, you have specific demographics that drive the cost of your plan. Understanding how to leverage those demographics to create a tailored plan is the key to creating cost-effective plans that keep employees happy.
After years of seeing so many factors play parts in an individual’s well-being, whether it be environmental, physical or mental, I learned that the human body has an enormous capacity to heal itself if given the right atmosphere and tools. I became an advocate and wanted to support others to do the same. I want to help people come to the same awareness that I did. Today, with my clients, if I can reach just one person at a time and help them to change and encourage their awareness, then I have done something good in this life.
Studies show that working-age adults are more likely to suffer from lengthy disabilities in any given year than they are to die. Unless it is offered through their employer, most adults have little, if any, disability insurance coverage, and when you become disabled and lose time at work, your source of income is eliminated. In addition to lost income, you are most likely experiencing an increase in medical expenses to deal with your disabling injury or illness.
Finding the right mental health professional requires a bit of work. If you are depressed or have another serious mental illness, it can be challenging to do that work on your own. If you are in this situation, ask family, friends or your primary physician for assistance.
Dr. Nelson is Director of Clinical Services at The Florida House Experience in Deerfield Beach. The Florida House is an innovative treatment center for mental health and substance use disorders that utilizes a whole person model treating clients medically, clinically, and with the latest technology to live happy and productive lives.
In recent years, electronic cigarettes, or e-cigarettes, have flooded the market. Many people are turning to e-cigarettes to help them quit smoking; however, questions remain about their safety and effectiveness.
Anxiety disorders affect over 57 million adults in America—more than 26 percent of the U.S. population. Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread. It is essential to seek treatment if fear is a daily component of your life.
On Jan. 5, 2018, the Department of Labor (DOL) announced that effective April 1, 2018, employee benefit plans must comply with new requirements for disability benefit claims.
Even though the brain and the heart are located far from one another in the body, they are intrinsically connected and have a significant impact on how each other functions.
On Jan. 22, 2018, President Donald Trump signed into law a short-term continuing spending resolution to end the government shutdown and continue funding through Feb. 8, 2018. The continuing resolution impacts three taxes and fees under the Affordable Care Act (ACA).
The IRS has again determined that some employers, insurers and other providers of Minimum Essential Coverage need additional time to gather and analyze the information and prepare the 2017 Forms 1095-B and 1095-C to be furnished to individuals. The attached ACA Bulletin outlines the new due date and additional information regarding this change.
Chief executive officers and presidents are usually the rock stars of their company and many times we only get to see one side of them. When it comes to our CEO and president Rachel Sapoznik, this is not the case – here are 30 facts you may not know about Rachel to round off Sapoznik’s 30-year anniversary.
On Dec. 20, 2017, the tax reform bill, called the Tax Cuts and Jobs Act, passed both the U.S. Senate and the U.S. House of Representatives. The bill is now expected to be signed into law by President Trump by the end of the day. This News Brief provides an overview of the tax reform bill and its potential impact on employers.
Employers have specific responsibilities under the ADA; failure to adhere to these responsibilities can result in lawsuits and significant penalties. There are steps employers can take to protect themselves from liability and avoid common ADA mistakes.
By providing diabetes management education and support for your employees, you can help them manage their conditions and remain productive workers.
The holiday season brings joy and togetherness; it can also bring stress to individuals and families. Fortunately, by getting organized and planning out what you can ahead of time, you can help reduce your holiday stress.
Many types of insurance may seem unnecessary, but they are designed to protect you in the event of an unexpected illness, accident, death or another event. Paying a small premium now can help protect you financially.
Many employee benefits are subject to annual dollar limits that are periodically increased for inflation. The Internal Revenue Service (IRS) recently announced cost-of-living adjustments to the annual dollar limits for various welfare and retirement plan limits for 2018.
The brain’s capacity is enormous, yet many scientists suggest that we only use a small percentage it. What are you doing to maximize your brain’s potential?
A quick and easy guide for employees and their health plans.
Confused about common health insurance benefits terms? These FAQs cover the basics to take the mystery out of coverage terms.
Choosing a doctor is a critical decision. Primary care doctors, specifically, typically provide you medical care over a long period, helping you stay healthy, manage your care and recommend specialists when needed. These guidelines will help you search for and choose a physician that will best suit you and your family’s needs.
During all the fun of Halloween, it is important to remember that this holiday requires some extra safety precautions.
The U.S. District Court for the District of Columbia has directed the Equal Employment Opportunity Commission (EEOC) to reconsider its final wellness rules under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).
The risk of disability is greater than most employees realize. When you become disabled and lose time at work, your source of income is eliminated. Nearly one-third of employees will miss more than one month of pay due to injury or illness. In addition to lost income, you are most likely experiencing an increase in medical expenses due to your disabling injury or illness.
For working-age individuals, disability refers to a medical condition that reduces your ability to perform your job duties. Disability insurance is coverage that provides you with income protection should you lose time on the job due to an injury or illness. With disability coverage, you receive partial replacement of lost income.
At open enrollment time, you have many decisions to make. Don’t let confusing terms trip you up. Refer to this handy list of commonly used terms.
Otherwise known as an HSA, a health savings account can be funded with your tax-exempt dollars, by your employer, by a family member or by anyone else on your behalf. Dollars from the account can help pay for eligible medical expenses not covered by an insurance plan, including the deductible, coinsurance, and even health insurance premiums, in some cases.
A healthy lifestyle supports disease prevention, and adding the following body-strengthening foods into your diet can really go the extra mile.
In order to get the most out of your health care benefits, you need to understand the terms used by insurance companies, the government, health plans and health care providers.
Each year, Medicare Part D requires group health plan sponsors to disclose to individuals eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable.
Equifax, one of the largest credit reporting agencies in the United States, was recently the victim of a massive cyber attack—an attack that may have compromised the personal information of 143 million people.
Hurricane Harvey and Hurricane Irma are the strongest storms to make landfall in the United States since Hurricane Charley in 2004. News of the damage is prompting people to help in whatever ways they can. Unfortunately, some dishonest people prey upon people’s good intentions, creating fake charity campaigns to exploit victims and take advantage of those who want to help.
Child Vaccinations: Don’t Wait to Vaccinate Nearly 4 million babies are born in the United States every year, and the U.S. Centers for Disease Control and Prevention (CDC) recommends vaccination against 16 vaccine-preventable diseases. Unfortunately, not all parents ensure their children are properly immunized. Keeping kids healthy Before vaccinations became widely available, diseases like measles, […]
In the early morning hours of July 28, 2017, members of the U.S. Senate voted 49-51 to reject a “skinny” version of a bill to repeal and replace the Affordable Care Act (ACA), called the Health Care Freedom Act (HCFA).
This was the final vote of the Senate’s 20-hour debate period, and effectively ends the Republicans’ current efforts to repeal and replace the ACA. However, the skinny repeal bill may be reintroduced at some point in the future.
On July 25, 2017, members of the U.S. Senate voted 50-50 to open up the American Health Care Act (AHCA) for debate and amendments in the Senate, with Vice President Mike Pence casting the tie-breaking vote in favor of the measure. The AHCA is the bill to repeal and replace the Affordable Care Act (ACA) that passed in the House of Representatives on May 4, 2017.
As a result of the vote, the Senate will now begin debate on the AHCA, as it was passed by the House. However, amendments are likely to be made to the bill before a final vote is taken. The Senate’s August recess has been delayed by two weeks to accommodate a vote on an ACA repeal and replacement bill.
On June 22, 2017, Republicans in the U.S. Senate released a draft of their proposal to repeal and replace the Affordable Care Act (ACA), called the Better Care Reconciliation Act (BCRA). The Senate bill closely mirrors the proposal passed in the House of Representatives—the American Health Care Act (AHCA)—with some differences.
Want to quit smoking, but finding it difficult? Many ex-smokers say quitting was the hardest thing they ever did. It’s okay to have mixed feelings about quitting, but don’t let that stop you. Find reasons to quit that are important to you.
On May 4, 2017, members of the U.S. House of Representatives voted 217-213 to pass the American Health Care Act (AHCA), after it had been amended several times. The AHCA is the proposed legislation to repeal and replace the Affordable Care Act (ACA).
The AHCA needed 216 votes to pass in the House. Ultimately, it passed on a party-line vote, with 217 Republicans and no Democrats voting in favor of the legislation. The AHCA will only need a simple majority vote in the Senate to pass.
If it passes both the House and the Senate, the AHCA would then go to President Donald Trump to be signed into law.
As of 2014, the Affordable Care Act (ACA) requires most individual and small group health insurance plans, including plans sold on the Marketplace and Medicaid Alternative Benefit Plans, to cover mental health and substance abuse disorder services. This includes behavioral health treatment, counseling, and psychotherapy.
Additionally, health plans must comply with the requirements set forth in the Mental Health Parity and Addiction Equity Act (MHPAEA), meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.
Autism spectrum disorders (ASDs) refer to a group of developmental disabilities that vary in severity and affect socialization, communication and other behaviors in those that have them. The Centers for Disease Control and Prevention (CDC) estimates that roughly 1 in 68 children have an ASD.
On March 6, 2017, Republican leadership in the U.S. House of Representatives issued two bills to repeal and replace the Affordable Care Act (ACA) through the budget reconciliation process. These bills, which were issued by the Ways and Means Committee and the Energy and Commerce Committee, are collectively known as the American Health Care Act.
Do you know your heart disease risk level?
On Jan. 20, 2017, President Donald Trump signed an executive order addressing the Affordable Care Act (ACA), as his first act as president. The order states that it is intended to “to minimize the unwarranted economic and regulatory burdens” of the ACA until the law can be repealed and eventually replaced.
On Jan. 13, 2017, the U.S. House of Representatives passed a budget resolution for fiscal year 2017 to begin the process of repealing the Affordable Care Act (ACA).
Rachel Sapoznik crusades to change how we think about health care and insurance.
Rachel Sapoznik’s life has been rich with life lessons. She realized as an adult that the team sports she played as a youth helped her build better executive teams.