BONUS 312: Individual Insurance Coverage

September 10, 2021

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Today’s bonus episode guest is Jon Belinkie, a broker at Health Insurance Specialists.

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Jon and Heather discuss how to get individual infertility insurance coverage:

INTRODUCTION

  • I’d like to start by hearing a little bit about you. Tell us who you are, where you work, what you do, and how you got to where you are today.
  • Why did you choose this career?

INSURANCE

  • Definitions:
    • Health insurance policy
    • Premium
    • Covered vs. uncovered
    • Deductible
    • Medical necessity
    • Medical benefit
  • Generally speaking, tell us about the different plan levels (bronze, silver, etc.) and what they mean in terms of percentage of expenses covered and premiums.
  • Tell us about public vs. private insurance.
  • What does it mean when an employer is fully-insured vs. self-insured?
  • What is a mandate to cover vs. a mandate to offer?
  • How might a company be exempt from mandates (total number of people employed, etc.)?
  • Tell us about group coverage.
  • Tell us about individual coverage.
  • Can you clarify for us the specific differences between group and individual coverage?
  • Are most people going through fertility treatments issued group or individual coverage?
  • When should people be investigating new plans? Does the timing differ between group and individual coverage? Why?
  • Does coverage vary between carriers and states?
  • Are we entering a better climate for these benefits given the new administration?
  • How do you and others in your industry get compensated for your services?
  • Is there anything else you’d like to add?

WRAPPING UP

  • What words of hope would you say to infertility warriors about obtaining individual insurance coverage for treatments?

References:

Thanks for listening!

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