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You may have recently heard about a Demand Studios health insurance program (a limited benefit medical program). Since Demand Media is the first content mill to offer a health care benefit to freelancers, we are taking a break from normal posting to give you some information about the plan. Pictures below are screen shots from the final information packet available on the Demand Studios website. Click on the pictures to see larger versions or visit the info packet and review the page numbers (cited below) to learn more about the Demand Studios health insurance program.
Demand Studios Health Insurance Plan Highlights (From their Website):
- No deductible or co-pays
- Guaranteed acceptance: There are no medical tests or requirements to disclose ailments or family history, etc.
- Pre-existing conditions are covered. The only exception is if you know you are pregnant, you cannot join the plan for that purpose. (Other than in California where there is no such requirement).
Re: Deductibles and co-pays- While the Demand Studios health insurance plan has no deductibles or co-pays, it does have out-of-pocket costs and it also does not offer the same limits as a traditional health insurance plan. In addition, any cost over the provided benefit will need to be paid by the patient:
Excerpt from page 4 - Note limits and amounts covered per plan option
Re: Pre-existing conditions- Per Demand Studios health insurance plan documents linked above, pre-existing conditions requiring critical illness care are not covered for 12 months:
From page 3
Demand Studios Health Insurance - Pros
- With this program, participants will visit a network of physicians who have agreed to provide discounted services to members. While the cost of your care may still exceed the benefit paid by the program, your total cost could amount to less than it would without the negotiated discount. Tip: Comprehensive health insurance plans generally offer negotiated rates (or usual and customary rate) when you visit in-network providers so that your expenses are limited even if you have to pay a coinsurance rate. If possible, speak with a local agent and find out if you can compare the negotiated rates of a comprehensive health insurance plan and the Flex Benefit Program. Be sure to factor in the co-pays or deductibles in the health insurance plan as well as the visit maximums in the Flex Benefit Program.
- The program includes vision benefits.
- The program includes dental discounts.
- The program includes prescription discounts. Tip: Check your local Publix, Wal-Mart or other pharmacy and find out what their prescriptions costs are for those you take regularly.
- You have access to a 24/7 nurse hotline.
Demand Studios Health Insurance - Cons
- The Beech Street PPO network may not have your healthcare providers or local hospitals in-network. Tip: Visit the Beech Street website to find out.
- The Demand Studios health insurance plan maximums may not cover the total cost of any doctor visit or procedure.Tip: Call your local Beechtree network doctor and find out if the doctor visit costs as much or less than the maximum benefit ($50-$75 depending on the plan you choose, see page 4). You may be able to do this for other services as well to help determine the value of the plan to you.
- There are no plan maximums, which means there is no cap to the amount you could spend out-of-pocket. Tip: Traditional health insurance plans generally offer out-of-pocket maximums. A plan with a deductible of $5,000 may seem high but if you check with your local agent, you can compare the out-of-pocket expenses and determine whether you actually have less at risk with a traditional health insurance plan and a deductible than you do with the FlexShield Benefit Program.
- The insurance benefit per prescription ($5, $10 or $15 depending on your plan) along with the prescription discount may not provide a substantial prescription savings. Also, participants with pre-existing conditions and a large number of prescriptions may find the coverage too limited. Tip: Check your local Publix, Wal-Mart or other pharmacy and find out what their prescriptions costs are for those you take regularly.
- The Critical illness coverage is once per lifetime.
- The Demand Studios health insurance option is not available to all writers working for the company. A content threshold must be met during a consecutive three-month period in order to determine eligibility.
Concerns you may want to address with an independent agent and IPS before you terminate any existing coverage for this Demand Studios health insurance plan:
- This program may not meet minimum creditable coverage standards in states like Massachusetts that require health coverage.
- In order to avoid pre-existing conditions waiting periods in group plans, you must have continued creditable coverage with no gaps of more than 63 days. If you give up your existing individual or group health insurance for this program and you or your spouse get a new job and request coverage under the group plan, your pre-existing conditions could be exempt for 12-18 months because you did not keep creditable coverage.
- If you give up COBRA coverage for this program, you will not be able to reinstate COBRA.
- If you leave a health insurance plan in favor of this program, you may not be protected under HIPAA.
- This program may not be as portable as an individual health insurance policy and offers no COBRA if you stop writing for Demand Studios (although there is no indication that this would be grounds for termination).
The Fine Print
Before you make any decisions to purchase this Demand Studios health insurance program or those offered by your local union, it is a good idea to explore alternatives with your local insurance agent. He or she can help you understand the real costs and risks associated with every limited benefit program and comprehensive health insurance plan. This post is not meant to encourage or discourage enrollment into the program.
* Yolander Prinzel is a licensed life, health and variable annuity agent (2-15). She does not actively solicit clients for insurance purchases or sell any insurance products. She is also not appointed to sell health insurance with any insurers.