Employer Health Plan Selection

It’s that time of year when we are faced with selecting our health benefits from the list of options provided by our employers. Unfortunately, understanding the difference between the options and the coverage provided is often difficult to unpack and we usually just choose the cheapest or just go with whatever option we selected last year.

There certainly isn’t any right or wrong selection or a blueprint for selecting coverage, however, selecting your healthcare plan should really be a full risk assessment considering many factors other than just pricing.

Here are 10 things you should consider when making your selection:

1. Are you single or married?

Have you considered the cost / coverage variance if you and your spouse are on the same plan or maintain two individual plans?

2. Do you have children?

Have you considered the cost / coverage variance if you cover the children on your plan or the other parent’s plan (or for you all the be on the same plan)?

3. How often do you go to the doctor?

Do you just go for annual check-ups (wellness visits)? If so, these are often free and have no copay

4. Do you have any pre-existing conditions that require Specialist (Non- primary care doc) visits

Do you mind getting referrals each time or would you prefer to just make an appointment directly with the Specialists

5. How much are you willing to pay out in the event of an emergency (MOOP)

This is relatively new with Affordable Care Act – every plan has a Maximum Out of Pocket Benefit (usually a separate one for in Network and Out of Network). This is the maximum amount of money you will have to pay in a given year in the event of a medical emergency / catastrophe.

Note: These are generally much higher for family plans than individual plans

6. Does your job offer a flex spending account?

Some people elect to take the ‘cheaper’ plan option and put a decent amount on their flex spending to cover some of the MOOP in the event of an emergency

7. Do you travel a lot?

If so, does your plan allow for coverage outside of your state / country?

8. Are you “life planning” for this year (e.g., planning to get pregnant)

Will you need to increase the amount you elect for short or long term disability depending on your company’s parental leave policy?

What is the cost of hospital stays or ER visits?

9. Copay vs coinsurance vs deductible

Important concepts to understand and see the impact of your selections:

o Deductible – This is usually the amount you will have to pay out of your pocket before the insurance company will begin making any payments (usually excludes wellness visits)

o Copay – This is the portion you will be required to pay at each visit to your provider (usually differs for PCP or Specialist – also something to consider if you need to see a specialist regularly)

o Coinsurance – This is often for Out of Network Coverage. Usually once the deductible has been paid, there is a percentage split of what your insurer will cover and what you will be responsible for (i.e., 80/20 – insurer will pay 80% and you will be responsible for 20%). This is not a big deal if the amount is $100, but in instances (and more realistically) when it’s $10,000 or $100,000 that could be a game changer. Fortunately, your MOOP will protect you against that. Once you’ve paid your MOOP for a given year, the insurer is responsible for the total remaining reimbursements to the provider. In my opinion this is the biggest benefit the Affordable Care Act provides, and probably explains why most insurers hate it.

10. Last but most, Cost

Taking into account all these factors, what can you actually afford as a deduction considering your other financial obligations, and what might you be willing or unwilling to risk as a result.

I hope this helps … If you have any additional questions, feel free to inbox me. I don’t know that I’ll have all (or any) of the answers but I wanted to help you become more informed when making these decisions that you’ll be locked into for an entire year.

Feel free to share this status so others might benefit from the information... but then again, what do I know

Invisible Man .... I finally see it now

Okay … so I finally finished reading “Invisible Man” (yes, it took me that long) and I take back all previous Ellison slander…. Ralph got bars!    I found myself highlighting quite a few that I thought were pretty sick (well phrased), profound, funny, or simply struck a chord with me.  Bars like:

“Time was as I was, but neither that time nor that “I” are anymore”

“History makes harsh demands of us all.  But they were demands that had to be met if men were to be the masters and not the victims of their times”

“I wanted freedom, not destruction.  It was exhausting, for no matter what the scheme I conceived, there was one constant flaw – myself.  There was no getting around it.  I could no more escape than I could think of my identity…..the two things are involved with each other.  When I discover who I am, I’ll be free.”

“Power doesn’t have to show off.  Power is confident, self-assuring, self-starting and self-stopping, self-warming and self-justifying.  When you have it, you know it”

“It was as though I’d learned suddenly to look around corners; images of past humiliations flickered through my head and I saw that they were more than separate experiences and my experiences were me, and no men, no matter how powerful they became, even if they conquered the world, could take that, or change one single itch, taunt, laugh, cry, scar, ache, rage or pain of it.”

“Somewhere in the audience an old woman’s voice began a plaintive wail; the birth of a sad, unformulated song that died stillborn in a sob”

“Two huge women with spoiled cream complexions”

“A man of striking ugliness; fat, with a bullet-head set on a short neck, with a nose much too wide for its face….”

While reading, it was easy to see that Ellison was more than just an author, but also a poet, a musician, an advocate for people (human rights), and for change.   However, there were several moments when I felt like he made the deliberate effort to display his diversity.   I didn’t need 2 pages worth of a description of grass or random references to different musical pieces or terms.  I thought those to be what I like to call “literary boasting” (© 2014).  Overall though, it was a very good read … once I got past the fluff, it was difficult to put it down…. I can see why it’s considered a classic….. but then again, what do I know!

Social NETWORKING, pt. 2

Obviously for all the reasons listed in my previous blog I love the social aspects of social networking, however, the single thing I love most is the actual NETWORKING!  Social networks, has allowed me to realize that I have built an expansive network of some amazing friends and associates.   Regardless of the topic, there is someone in my network who is a subject matter expert (SME) I can reach out to.   I have reached out to a number of you for your help, advice, guidance, or just general information and you have all been gracious.  A wise man once said “you’re only as successful as your network” (I may have made that quote up.. but, whatever .. it works .. lol) and I am grateful to have you all in mine! 

As a result, I decided to write a few tips on how to network successfully on social networks:

1)      Build your own value/worth

I believe that as humans we have an innate selfish nature and drive (some of us more than others).  As a result, people are more likely to help someone they think they could possibly need to reach back to one day.  If you only portray negativity in your posts, or aren’t showing signs of progressing yourself or positive things that you are doing, it probably weakens your chances of getting a response when you reach out to someone.

2)      Share the wealth

If you have some information that you believe someone can benefit from, even if you can’t (ie: job postings, housing opportunities, info about the latest things happening in certain market segments) SHARE THE INFORMATION.   People on your timeline will remember that you also share information and are more likely willing to share with you.

3)      Do your homework first

Please don’t reach out to your network asking for advice or information that is easily accessible.  Instead, do your own research first.  Show them that you have performed your due diligence and they will be more likely to fill in the piece of the puzzle that you are missing.  Don’t just expect them to hand you a road map to achieve the same level of success that they spent countless hours working hard to attain.

4)       ‘Number four shoulda been number one to me’ (Greg remix):  Networking <> Hook Up

A popular misconception is that networking = hookup!  People expect that because a friend is in a trusted position of authority that entitles them to the access.  As a result, a lot of people are afraid to even let others know where they work, because others are looking for a discount, or a job offer, etc …  When you network, your only expectation should be knowledge… anything extra is an added bonus… don’t expect people to risk their jobs for you.

5)      Yes, they’re your friend .. Yes, they own the business … No, you shouldn’t get a discount

If someone in your network has their own business and is very good at their craft, you should by all means support their business.  That is how our network grows stronger.  However, just because you knew them from elementary school (cue Big Pun) doesn’t entitle you to “take food out of their mouth”.  If you notice a competitor has a cheaper rate for the same service, then feel free to negotiate based on that, but don’t feel entitled or think differently of the friendship if they say no.  It then becomes your choice if you’ll still use them or the competitor.

6)      Say “Thank You!” even if all they were able to do was listen.

There are those few times when we reach out to people and they are unable to help.   Either they didn’t know the information you were looking for, were unable to grant the favor requested, or didn’t provide any additional knowledge to what you already knew.   The fact is, they were willing to listen (or read the email) and for that you should be show gratitude.  It will also make them more likely to help the next time you reach  out or if they happen to gain that information in the future.

7)      Pay it forward

Finally, if someone reaches out to you for information or help, don’t hesitate to  reach out and lend that helping hand!

But then again, what do I know…

SOCIAL networking Pt. 1

Over the course of my 35 years, I have been blessed to have attended some “good schools” and take advantage of some great personal and professional opportunities.  Invariably, as each of those opportunities came to an end (graduation, another opportunity, etc..), you always exchange daps and hugs with everyone and say the obligatory “Make sure you keep in touch!”, “Don’t forget us!”,  and “Here’s my info, hit me up!!”, which I’ve learned over the years was actually just a nice way of saying “Goodbye!”, “It’s been real!”, or “Catch you next lifetime!”.

We’re probably all guilty of this and it’s certainly not intentional, we absolutely intended on keeping in touch, but your good intent is often replaced with trying to cope and balance new challenges, opportunities, and sometimes new  friends (sorry, Drake!) which just made it impossible… until Social Networks!

One of the things I love about social networks is that it has afforded me the opportunity to rekindle and maintain some lost friendships, meet and interact with people who I didn’t get a chance to interact with much (or at all) in those former schools and opportunities, and just keep a finger on the pulse of what’s happening in my friends’ lives when mine sometimes gets too busy to even place a call (but not too busy to check social networks, obviously … nobody’s that busy! … lol).  

Whether, it’s a simple comment on a post (ratchet or uplifting, personal or professional, serious or funny), a quick “hello” through an inbox, or just seeing you post something on your page, I know you’re doing well (or at least well enough … well, most of you … some of you I can see the tears streaming through those motivational memes... lol ), I appreciate you all and I’m happy to have you as “friends”.   

But then again …. What do I know?!!

Be-You-tiful....

Yesterday, a friend of mine wrote a one word status that resonated strongly with me .... she simply wrote: 'Be-You-tiful...'

A status so simple, yet so powerful!

This status, obviously a play on the word beautiful (no reader left behind :-)), reflects on a word I've heard pronounced this way several times, but something about seeing it spelled out like that spoke volumes.

It's a reminder that everyone is beautiful in their own way.  There is a distinct beauty in being you!

We sometimes end up comparing our 'beauty' to others forgetting to take some time to reflect on the beauty that is you....

Be reminded that your beauty isn't just physical, it starts within and whenever you compare it to, or try to be someone else, you're robbing the world of seeing the beauty that is you....

We're all fearfully and wonderfully made! ... and might I say some of you, very wonderfully ... sorry, I digress...

But as you go through your day today and everyday, don't forget to Be-You-tiful!  It looks good on you!!

But then again, what do I know....

Look at God.....

Every so often in various cultures, there are tons of catch phrases that emerge and become so wildly popular and overused that you begin to cringe each time you hear them.  We have all become exhausted with phrases like "ratchet", "turn up", "have a seat (or several)", and "YOLO".  Even at church the catch phrases are there: we hear "But God", the elongated "yeeees", etc ... 

Over the last few months, the one I notice becoming most popular is "Look at God!! ...." and just like all the others, I see and hear it everywhere: hashtags, fb statuses, testimonies, etc and usually by this point the cringing would begin for me, but for some reason I can't get enough of that phrase ... I absolutely love it!

I love it in all the many ways I see see it referenced, whether it's:

A lighthearted praise: "Look there was one pack of strawberry waffles left on the shelf just for me .. Look at God!!" 

An appreciation for the other gender with your friends: "You see all that wagon she draggin?!  .. Look at God!!"

A testimony: "I had no money and didn't know how my bills would get paid, but I prayed and all of a sudden somehow the money was provided .... Look at God!!" 

I started to lend some thought as to why I haven't grown weary of this phrase and I think it's because it's a bit deeper for me ... 

I sometimes argue that one of the reasons Jesus was able to go sinless on earth was because he didn't really have to exercise faith, it was more an exercise of will power.  If he was just in Heaven chillin with God and witnessed all the times they bailed people out and came through for them, then while he's on earth, he KNOWS there's a God, because he's actually seen him... however, he may have still been tempted to turn stones to bread because he's hungry which makes it more willpower in my opinion (but anyway, I've digressed)

I have always been a natural skeptic and relied heavily on logic and sight to believe things.  I need to see it to believe it! ... and it holds firm in most aspects of my life.... and then there's my faith.

As a believer we are taught to rely most heavily on our faith.  This practice is always easiest when things are going extremely well in our lives.  We see the blessings pouring in and we credit God!   However, sometimes it's not as apparent because there are no mind blowing miracles occurring, or worse when things seem to be going "terribly awry" in our lives.  This is when our once unwavering faith starts to get weak and we begin to even doubt His existence... and this is probably because we've never actually physically seen Him.... 

For me personally, I feel like the expression "Look at God!!" is His way of saying, yes Greg, you have actually seen me and you have actually seen me often.... but let me make it a little more plain for you since you are a skeptic, I'm gonna make you see me a lot!  

So now everytime someone is blessed, whether it be major or minor and I see or hear them say "Look at God!!", I smile, and think "aiight God, you got it ... I see you Big Homie!" ..

but then again, what do I know

Be SMART in 2014

Wow, I can't even fathom that 2013 is over already!!   Each year seems to fly by faster than the previous one!  Although 2013 had some bad and ugly in it, those were all far exceeded by the good.   I was able to see a milestone birthday (35), and accomplish just about all my personal and professional goals this year!

While reflecting on the past year, I started to lend some thought as to why this year was better than the previous and of course I recognize that God has His hand in my life and has allowed the blessings to flow in, but there were also several things I did differently that I think we can all adapt that made a major difference with the hopes of us all having an even better 2014:

1) Set SMART goals, NOT Resolutions

SMART is an acronym that stands for "Specific, Measurable, Attainable, Realistic, and Timebound".  One of the reasons my 'resolutions' failed in previous years were because they were too open ended, unrealistic, or not within a specific time frame.  Aren't we all guilty of these (ie: i want to save money,  I want to lose weight, I'm going to start going to the gym 7 days a week, I'm gonna do 3 charity events, etc...)

Note: for the remainder of this blog I will use the weight loss example to emphasize my points, primarily because this is probably most of our New Year's Resolution which is probably why the gym is always so full in January .... but hopefully you can draw a line of sight to how this applies to any of your 'resolutions' or goals.

• A) If you don't set a SPECIFIC and MEASURABLE target then you won't be able identify your ultimate goal and track your progress.  For instance, if you don't set a specific number for weight loss, then technically one pound would make you accomplish that goal, but we all know you ain't making no resolution for 1 pound .. lol   

• Additionally, without a specific number, you won't be able to track and measure when you are making progress.  Measuring progress can be as simple as keeping a log to track it as you go along, benchmarking against where you were when you started and identifying things that you couldn't do before (ie: pushups, pullups, run a mile without stopping, etc, or even pictures).  

• These will help you out when you start to get discouraged if you think you are not progressing as fast as you would like, and help to serve as a reminder that you are much further along than when you started.

• B) Ensure your goals are ATTAINABLE, REALISTIC, and TIMEBOUND.  These go hand in hand.  Yes, losing 30 pounds, or going from a sedentary lifestyle to a gym rat 7 days a week is attainable, but not within one month.  Be realistic with yourself.  What is the overall goal you would like to accomplish and by when can you seriously expect to accomplish it.  This doesn't mean to be afraid to challenge yourself with stretch goals, but if the overall goal is to lose 30 pounds set a realistic time frame for accomplishing the goal, and/or set sub milestones ... they say the best way to eat an elephant is one bite at a time ...  but then again, that's gotta work against your weight loss goals... lol 

2) Prioritize Goals

You can't accomplish everything at once.   Set your priorities, put them in order .. Identify which ones are more important, and which ones are easiest to accomplish.  Do the easiest ones first .. that will help build momentum  ... set separate dates to accomplish things and check them off the list one by one

3) Dont do it all at once (Action Plans)

Once you've identified and prioritized your goals, the most important part is creating action plans on how to accomplish them.  It's not good enough to just identify the goal, but also identify the things that need to happen to accomplish them and so on...

Ie:  Lose 30 lbs

• Make better food choices
• Write grocery shopping list
• Only buy items on list
• Only 1 cheat meal per week (Thursday night this week)
•  Go to the gym 3 times a week
• Get gym membership (by Friday)
• Create gym schedule every week to figure out which 3 days I can go and if I need to go Mornings or evenings to ensure I get my 3 days in (Every Sunday)
• Pack gym bag night before

4) Celebrate Success

When you have accomplished some of your goals or milestones, don't forget to celebrate success.  You should be proud of each goal achieved.  Be sure to share it with someone .. or probably all of us via your fb feed or something!

5) Create new Goals! 

Don't be satisfied because you accomplished a few goals... not that you have accomplished those and the momentum is on... set some new ones and accomplish those!

Hopefully this helps and contribute towards us all having a very successful 2014!! ..

But then again, what do I know ....