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Colorado Health
Insurance
Kris Willy's Blog
NAME: Kris J. Willy
TITLE: Health Insurance Guru
EMPLOYER: Owner of The Colorado Health Solutions Agency
LOCATION: Colorado

Welcome to
Colorado Health
Solutions
Since this
is my very
first blog
posting I
would like
to welcome
you and say
thanks for
stopping by.
The
intention of
this bog is
to inform
you of ideas
and changes
that I will
run into and
learn about
every day.
If I run
across
something
that I feel
you will
benefit
from, I will
definitely
post it
here.
This blog
will contain
Colorado
Health
Insurance
information,
ideas,
facts,
changes in
carriers
plans and
rates,
client's
stories and
experiences,
and just
about
anything
else I feel
you should
know.
Feel free to
drop my a
line at
anytime with
ideas or
suggestions
at
Kris@ColoradoHealthSolutions.com
Once again I
thank you
and look
forward to
hearing from
you!
Kris Willy
Kris@ColoradoHealthSolutions.com
Your Colorado
Health Insurance
Specialist
Annual
Rate
Increases
This is
the time
of year
most
people
will be
getting
their
annual
health
insurance
rate
increases. Some
will be
manageable,
some
will be
un-manageable. I get
asked
the
question
time and
time
again,
"the
health
insurance
company
is
singling
me out
based on
claims",
or "why
did I
get a
30% rate
increase
when I
didn't
even see
the
doctor
once
last
year?". Listen,
no one
wants to
get a
rate
increase,
but it's
going to
happen
from
year to
year. There is
a
formula
behind
how the
insurance
companies
adjust
your
rates,
here is
the
breakdown
and how
it is
done:
If
you've
ever
read
your
policy
you may
have
seen
this "We
reserve
the
right to
periodically
adjust
the
premium
rates
charged
for
coverage's
under
the
policy." Ok that
seems
pretty
straight
forward,
but what
do they
really
mean?
Premium
rates
are
calculated
based
upon
numerous
factors
such as:
1)
New
business
rates -
Insurance
companies
will
adjust
the
rates
based on
the
volume
of new
business,
as they
say the
more the
merrier!
2)
Provider
network
- Each
health
insurance
company
has it's
own
network
they
either
share or
own. If
doctors
inside
this
network
negotiate
different
rates
from
year to
year you
will see
a higher
or lower
adjustment.
3)
Geographic
location
- Yes
you may
be
charged
more
because
you live
in the
mountains. Each zip
code has
it's own
adjusted
rate
with
each
carrier. It
basically
comes
down to
how much
medical
treatment
costs in
the area
you
live. This is
why it
is
recommended
you shop
around
to find
the best
rate
based on
where
you
live.
4)
Age -
Everyone
should
know
this
one, you
will pay
more
from
year to
year
based on
your
age.
5)
Gender -
Most
people
say,
it's
illegal
for
insurance
companies
to
single
out
based on
sex. No it's
not in
health
insurance,
as a
rule of
thumb
female
will
generally
cost
more to
insure
up to a
certain
age.
6)
Tobacco
usage
status -
Pretty
straight
forward,
if you
smoke of
use
tobacco
products
you will
pay
more. An
average
of
30-40%
more
than a
non-tobacco
user.
7)
Medical
trend -
Are
doctor's
and
hospitals
charging
more for
a given
procedure
this
year
than
last? This is
yet
another
factor
that
comes
into
play
when
your
rates
are
adjusted.
8)
Durational
rating
factors
- How
long
have you
been on
your
policy? Odds are
the
longer
you're
with a
company
the
higher
the rate
increase
you will
get. It
simply
comes
down to
the size
of the
block of
insured's
you're
with. I'll
explain
in the
next
paragraph.
9)
Health
status
of the
entire
block of
insured's
in which
you are
included
- Ahh
here is
the
biggie! When you
sign up
on a
health
insurance
plan you
are
lumped
into a
block of
insured's. Let's
call
this
block
you're
in block
X. The
first
year you
have
decent
rates,
then
bam! Your
rates go
up 30%,
what
happened? Odds are
that you
are
lumped
into an
un-healthy
block of
insured's. What
happens
when you
get a
30% rate
increase? You
start
shopping
around,
and so
do the
other
people
in your
block. So now
all the
"healthy"
people
end up
leaving
the
block
you're
in which
leaves
who in
the
current
block X? The
un-healthy
who can
not
switch
now that
they are
"uninsurable". So the
un-healthy
have to
stay in
the
block
due to
pre-existing
conditions,
therefore
using
their
health
plans
more and
more. The size
of your
block
has now
shrunk
to the
point
that the
health
insurance
company
is now
paying
out more
than
they are
getting
in from
premiums.
What
happens
next
year, an
even
bigger
rate
increase! This is
why it
is
important
to at
least
price
out new
policies
from
year to
year.
10)
And
other
factors
as
permitted
under
state
law - No
one
really
knows
what
they
mean by
this, I
guess
you can
contact
the
state
insurance
commissioner
to get
the
answer
to this
one.
We
specialize
in
finding
you
affordable
health
insurance
based on
your
needs
and
budget. There
are new
health
insurance
plans
that
come out
from
year to
year
that
WILL
save you
money. Is your
current
broker
or agent
showing
you
these
plans? If not
shouldn't
you have
a broker
that
will? Let me
know if
I can be
of any
service
to you
now or
in the
future.
Our
clients
are why
we are
in
business!
Have a
great
holiday
and stay
healthy!
Kris Willy
$4 Generic
prescription
drugs are
becoming more
common!
As most people
currently taking
prescription
drugs have found
out, Wal-Mart
and Sam's Club
are currently
offering a
pretty decent
size list of
generic drugs
for only $4. (30
day supply)
As I assumed we
are now going to
see more and
more companies
joining in on
the fun.
Who is the next
in line?
How about
Target!
"Target
tags
drugs
at
$4
Target
Corp.
said
it
will
sell
certain
generic
prescription
drugs
for
$4
at
all
of
its
pharmacies,
effective
immediately.
The
rollout
affects
slightly
more
than
300
drugs,
formulations
and
dosages,
including
popular
medicines
such
as
prednisone,
tetracycline,
amoxicillin
and
erythromycin.
Target
has
at
least
19
Denver-area
stores
with
pharmacies.
Target
said
it
made
the
move
to
avoid
confusion
among
its
customers.
Kris Willy
Most People
Underestimate
Health Care
Costs!

I recently read an informative article the other day that really didn't surprise me one bit. It had to do with people underestimating the cost of health care in this country. Honestly, I talk to people everyday who are ignorant to the cost of an overnight hospital stay as well as other medical procedures. For example, I spoke with a female at Starbucks the other day and she said that she is going to pay out of her own pocket the cost of a physical exam, as opposed to getting a health plan that would cover it or at least help pay for the testing. I then asked her, "How much do you think a complete physical exam costs someone who isn't insured? She said, oh probably about $75. I kind of chuckled and told her the procedure normally costs anywhere from $300 to $500. She was very surprised, as are so many other people when they realize the cost of health care today.
Make Sure You're
In Network!
Please
remember to run
a network search
before you see
any doctor, go
to any lab
facility or any
hospital unless
it's an
emergency. If
it's a
non-emergency
and you see a
non-network
provider you may
be responsible
for the charges
between the
network price
and the total
charge. If
you're unsure
about how to run
a network search
or forgot which
network you are
in please call
me, I'm always
here to assist
you.
I also encourage
you to call me
before a
scheduled
surgical
procedure so I
can make sure
all providers
and facilities
are in network.
I will also make
sure any and all
pre-authorization
requirements are
met. Simply
call or e-mail
me and I will do
the rest for
you!
Kris, am
I going
to be in
network?
Understanding
Your Medical
Bills!
After
your
doctor's
appointment,
your
doctor's
office
submits
a
bill
to
your
insurance
company.
A
claim
lists
the
services
your
doctor
provided
to
you
for
that
visit.
The
insurance
company
uses
the
information
in
the
claim
to
pay
the
doctor
for
those
services.
When
the
insurance
company
pays
your
doctor,
it
usually
sends
you
a
report
called
an
EOB,
or
an
Explanation
of
Benefits
that
shows
you
what
it
did.
You
need
to
be
able
to
read
and
understand
the
EOB
to
know
what
your
insurance
company
is
paying
for,
what
it's
not
paying
for,
and
why.
FYI,
an
EOB
is
not
a
bill.
Your
doctor's
office
might
send
you
a
statement.
A
statement
shows
how
much
your
doctor's
office
billed
your
insurance
company
for
the
services
you
received.
If
you
receive
a
statement
before
your
insurance
company
pays
your
doctor,
you
do
not
need
to
pay
the
amounts
listed
at
that
time.
After
your
insurance
company
pays
your
doctor,
you
may
need
to
pay
the
doctor
any
balance
due
if
any.
Here
are
some
things
to
look
for:
- If the dates of service and description of services on your EOB and billing statement aren't the same, or if they don't match other records you may have of the visit, contact your doctor's office first to verify.
- If you have questions about why your insurance company did not cover something or about the amount you have to pay, contact me immediately and I will look into it for you.
Finally,
you
should
keep
your
EOB's
and
statements
organized
so
that
you
can
access
them
easily
should
questions
arise.
The
bottom
line
is
all
insurance
companies
are
going
to
pay
benefits
based
on
the
"coding"
that
comes
from
the
insurance
company.
If a
doctor
or
hospital
codes
a
procedure
incorrectly,
the
insurance
carrier
may
not
pay
the
claim
based
on
your
policy's
benefits.
If
you
ever
assume
or
think
that
a
procedure
or
doctor's
visit
is
not
coded
correctly,
please
call
me
and
we
can
verify.
Doctor's
and
hospitals
can
easily
re-code
a
procedure
with
can
make
all
the
difference
on
whether
a
claim
is
paid
or
denied.
Are you really
getting the most
out of your
current Life
Insurance
policy?
Term
Rates
have
dropped
and are
lower
than
ever
right
now! If
you
haven't
looked
at your
current
policy
and
coverage
amounts
I highly
recommend
doing
so!
Over 90%
of the
time I
can get
you more
coverage
and
protection
for the
same
price or
for less
than you
are
paying
right
now!
I work
with
hundreds
of
companies
and can
help you
maximize
your
current
policy!
Either
call or
send me
an
e-mail
and I
will see
if there
is a
better
options
available
to you!
It
doesn't
hurt to
at least
look!
Hospitals
Charging the
Uninsured More!
"Patients
without
insurance and
those who pay
out of pocket
were charged
more for
services,
according to a
study published
in the May-June
issue of the
journal Health
Affairs.
In 2004, those
who paid for
their own
medical care
were charged
2.57 times as
much on average
as those with
health
insurance.
While that
number has risen
steadily since
1984, the most
significant
increases have
occurred since
2000."
I found this
article in the
July issue of
the Agents
Journal. I run
into people
every single day
who are
uninsured that
tell me the same
thing, "If I get
sick or hurt
I'll just pay
for it out of
pocket." You
can do that, but
you will not
only be paying
more, but you
also take on the
risk of being
financially
ruined. I then
proceed to ask
them this, "If
you get hurt and
wind up in the
hospital for a
week, how are
you going to pay
the $50,000
bill?" I get a
deer in the
headlight look
for a second,
then they
respond, "I'll
just file
medical
bankruptcy or
pay $25 a
month." I
continue to tell
them hospitals
will usually
require 5-10% of
the total bill
each month.
Then ask them if
they know that
the bankruptcy
laws have
recently
changed, and it
is now pretty
much impossible
to write off
your medical
bills. If you
have assets,
house, car,
property,
retirement, a
business etc.
they can and
will take it
from you! I've
seen it happen
first hand, and
it's not pretty.
I look at it
this way, if I
were to get sick
or hurt and wind
up in the
hospital I can
manage and pay a
$5,000 to
$10,000
deductible or
bill. But if I
were to take the
huge risk and go
uninsured,
myself as well
as most people
will find it
difficult to
recover from and
pay a $50,000
bill. What if
the bill was
$250,000? You
don't think the
hospital and
doctors will
come after you
for this? If
you have assets
they can and
will make you
liquidate them
to pay your
bills, again
I've seen it
happen!
So the next
time you talk
with a friend or
a family member
who is
uninsured, ask
them why? If
they think they
can't afford
Colorado health
insurance they
are wrong! They
just can't
afford the
extremely
benefit rich low
deductible
plan. They CAN
however afford a
higher
deductible
catastrophic
plan which WILL
protect
everything
they've worked
so hard for in
life.
If you know
someone who is
uninsured or
underinsured I'd
love to help
them out.
Please pass
along my contact
info so I can
help them get
protected.
Disturbingly
Useful
Health
Tips!
I found
this
interesting
little
article
on
msn.com
the
other
day.
And for
the
record,
no I
haven't
tried
them
yet, but
I'm in a
trusting
mood.
Enjoy!
1. If
your
throat
tickles,
scratch
your
ear!
When you
were 9,
playing
your
armpit
was a
cool
trick.
Now, as
an
adult,
you can
still
appreciate
a good
body-based
feat,
but
you're
more
discriminating.
Take
that
tickle
in your
throat;
it's not
worth
gagging
over.
Here's a
better
way to
scratch
your
itch:
"When
the
nerves
in the
ear are
stimulated,
it
creates
a reflex
in the
throat
that can
cause a
muscle
spasm,"
says
Scott
Schaffer,
M.D.,
president
of an
ear,
nose and
throat
specialty
center
in
Gibbsboro,
New
Jersey.
"This
spasm
relieves
the
tickle."
2.
Clear
your
stuffed
nose!
Forget
Sudafed.
An
easier,
quicker,
and
cheaper
way to
relieve
sinus
pressure
is by
alternately
thrusting
your
tongue
against
the roof
of your
mouth,
then
pressing
between
your
eyebrows
with one
finger.
This
causes
the
vomer
bone,
which
runs
through
the
nasal
passages
to the
mouth,
to rock
back and
forth,
says
Lisa
DeStefano,
D.O., an
assistant
professor
at the
Michigan
State
University
college
of
osteopathic
medicine.
The
motion
loosens
congestion;
after 20
seconds,
you'll
feel
your
sinuses
start to
drain.
3.
Thaw
your
brain!
Too much
Chipwich
too fast
will
freeze
the
brains
of
lesser
men. As
for you,
press
your
tongue
flat
against
the roof
of your
mouth,
covering
as much
as you
can.
"Since
the
nerves
in the
roof of
your
mouth
get
extremely
cold,
your
body
thinks
your
brain is
freezing,
too,"
says Abo.
"In
compensating,
it
overheats,
causing
an
ice-cream
headache."
The more
pressure
you
apply to
the roof
of your
mouth,
the
faster
your
headache
will
subside.
4.
Wake the
dead!
If your
hand
falls
asleep
while
you're
driving
or
sitting
in an
odd
position,
rock
your
head
from
side to
side.
It'll
painlessly
banish
your
pins and
needles
in less
than a
minute,
says Dr.
DeStefano.
A tingly
hand or
arm is
often
the
result
of
compression
in the
bundle
of
nerves
in your
neck;
loosening
your
neck
muscles
releases
the
pressure.
Compressed
nerves
lower in
the body
govern
the
feet, so
don't
let your
sleeping
dogs
lie.
Stand up
and walk
around.
Medical
Fact
or
Fiction?
 I
ran
across
an
interesting
article
the
other
day that
I though
you
might
get a
kick out
of. I
remember
my
grandmother
telling
us as
kids,
"don't
go
outside
with a
wet
head,
you'll
catch a
cold".
Was she
correct
on this?
This
article
was
written
and
published
by Dr.
Isadore
Rosenfeld
on
January
22,
2006.
You
don't
catch
cold
because
you're
chilled
or
exposed
to a
draft.
Fact or
fiction?
Fiction!
We used
to think
that
colds
are more
common
in
winter
simply
because
people
spend
more
time
indoors,
where
they are
exposed
to each
other's
germs.
Cold
weather
was not
believed
to have
anything
to do
with it.
However,
recent
research
suggests
that
when you
are
chilled,
the
blood
vessels
in your
nose
constrict
and
deliver
less
warm
blood to
its
lining-which
means
fewer
white
blood
cells to
boost
the
immune
system
and
fight
disease.
If you
happen
to be
harboring
a cold
virus
but
don't as
yet have
any
symptoms,
this
decreased
supply
of white
blood
cells
allows
the
virus to
multiply
and give
you a
full-blown
cold.
Chocolate
reduces
the
absorption
of
calcium
in a
person's
diet.
Fact or
Fiction?
Fact!
Many
foods
that are
high in
oxalic
acid-including
spinach,
rhubarb,
chard
and
chocolate-reduce
calcium
absorption
in the
small
intestine
because
they
combine
with the
calcium
to form
an
insoluble
salt
that the
body
cannot
use.
Eating
grilled
food can
cause
cancer.
Fact or
Fiction?
True-to
some
extent!
In areas
of the
world
where
grilled
meat is
frequently
eaten
(such as
Japan),
there is
a high-er
incidence
of
stomach
cancer.
That's
because
prolonged
barbecuing
of meat
at high
temperatures
forms
cancer-causing
compounds
on the
charred
areas of
the
food.
Carcinogens
also are
present
in the
smoke
released
by meat
on the
grill.
So, it's
a good
idea to
limit
your
consumption
of
barbecued
meats to
days
when you
can't
resist
the
temptation
to cook
outdoors.
When you
do so,
try not
to char
the
food.
Keep the
heat low
and the
cooking
time
relatively
short
(but
long
enough
to kill
any
bacteria).
Eating
and
drinking
dairy
products
when you
are
congested
makes
the
phlegm
thicker
and more
difficult
to
expectorate.
Fact or
Fiction?
Several
studies
have
questioned
the
truth of
this
widely
held
belief.
However,
many
doctors
(and
patients)
remain
convinced
that
milk and
other
dairy
products
do tend
either
to cause
more
phlegm
or to
make it
thicker.
This is
presumably
due to
the fat
and
casein
(protein)
in dairy
foods.
If you
like
milk and
cheese,
try them
when you
are
congested
and see
what
happens.
If they
make the
phlegm
worse,
hold off
until
you're
healthy
again.
Technorati Profile

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What our client's are saying:
The fact of
getting multiple rate quotes so quick and easily
was what prompted me into doing it, and will in
the end save me quite a bit of money.
All the rates you show are
from quality insurers and many were considerably
lower than what I pay now. Even
better, you're going to lower my overall
exposure financially. Thanks Kris!
Carol & Dirk
Castle Rock, CO
"Service
overall: 10 out of a possible 10!" You
rock!
Jennifer
Grand Junction, CO
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