Supplemental Health Insurance

Gillespie Insurance Services is proud to offer Supplemental Health Insurance.

What is Supplemental Health Insurance?

Supplemental Health Insurance (SHI) is a health insurance policy that provides coverage for specified situations and pays a lump sum at specified predetermined amounts. Unlike traditional health insurance, SHI:

1. Pays specific pre-determined lump sums for each covered situation, and;
2. It pays you directly, not the doctor, hospital, clinic, or medical facility.

What Types of Situations Does Supplemental Health Insurance Provide Coverage For?

Here are some examples of specific situations you can get covered for:

• Accident – coverage would apply if you had an off-the-job accident that results in injury.
• Cancer – coverage would apply if you were diagnosed with cancer.
• Critical Care – coverage would apply for serious medical conditions such as a heart attack, stroke, or major organ transplant.
• Short Term Disability – coverage would apply if you’re unable to work due to a covered illness or injury that occurs off the job.
• Hospital Indemnity – coverage would apply if you had to stay in a hospital for a specified period of time, typically 24 hours.

Note: coverage applies based on the plan that you decide to purchase. You can buy one coverage or all them – or you can pick and choose!

Does Supplemental Health Insurance Replace My Existing Health Plan?

No, absolutely not. Typically, SHI acts as additional insurance that complements your primary health insurance plan. It is not meant to replace your current health plan. If you have health insurance, you would keep your insurance in place. SHI, however, exists on its own. You can purchase it whether or not you have other insurance in place. Typically, SHI will provide coverage where your primary health policy does not.

Why Would I Need Supplemental Health Insurance if I Already Have Health Insurance?

Because SHI pays money directly to you – and you can do what you want with it! People often think of SHI as “gap” insurance because it fills the gaps left by your traditional health insurance. Here are the things people typically use their payouts for:

• Paying their health insurance co-pay they are responsible for.
• Paying their health insurance deductible they are responsible for.
• Paying the direct medical costs if/when their health insurance doesn’t provide coverage.
• Paying the direct medical costs if there is no health insurance in place.
• Paying for regular daily use items, like food, clothes, and household goods (this is typical when you have received a disability payment)

How Do I Get Paid? How Does the Claims Process Work?

The process of filing a claim is remarkably simple. Here is an example of Accident coverage in action:

• You’re riding your bike and you run into a fire hydrant, landing on your wrist. You feel like you may have broken it or at least sprained it really bad. You go to the ER.
• At the ER, you provide your traditional health insurance information, as they ask for it. (You won’t be required to show any proof of SHI).
• When you get home from the ER, you call your SHI agent or the SHI insurer directly and file the claim, describing the biking accident.
• You will then provide the medical document(s) requested by the SHI insurer to show your covered incident.
• Shortly after, you receive a check in the mail or a direct deposit into your designated account for the lump sum you are entitled to.

Is Supplemental Health Insurance Available for Groups as Well as Individuals?

Yes! SHI is available for both groups and individuals. Typically, the best rates are found in a group placed through a business entity as a company benefit provided to employees. Also, qualifying as a group for SHI is much easier than it is for traditional health insurance. For example, most SHI carriers will allow a group to qualify as long as there are three participants willing to sign up. The participants can be owners, employees, or dependents.

Besides the Coverages Themselves, Why Would a Business Want to Provide Supplemental Health Insurance as a Company-Sponsored Benefit?

Sometimes the side benefits are the best part of a company-sponsored SHI plan. SHI does much more for your company than just pay certain medical bills. Here are the top three.

ONE – SHI can be a great risk management tool, particularly when it comes to workers comp fraud protection. To explain; occasionally, an injured employee wasn’t actually injured on the job. But since they either don’t have health insurance or they don’t have enough cash to pay their deductible or co-pays, they may fraudulently file a claim on the company’s workers comp policy. With Accident and Disability SHI in place, the employee will rightfully file a claim with SHI. The direct payment to employees greatly reduces the incentive for them to act dishonestly. Fewer claims on your workers comp means lower rates for you in both the short and long term. This can be a massive savings to a business.

TWO – SHI can lower your company’s tax burden because it is tax-deductible. When your employees pay for SHI through payroll deductions, their taxable income is reduced and your payroll tax obligation is lowered.

THREE – Offering benefits improves employee recruiting and retention. Not every business can afford to offer group health. But for a fraction of the cost, virtually every business can afford to offer SHI. It can be a real advantage to offer SHI in an industry that typically doesn’t offer group health. Contractors, food service, janitorial, retail – these are just a few classes of business that aren’t known to include a benefits package, so to be able to do so with a simple effective SHI plan can attract and keep the types of employees you want working for you.

How Much Does Supplemental Health Insurance Cost?

SHI is actually very affordable. How affordable? Let’s just say: much less than traditional health insurance. Every policy will be a little different based on these variables:

• Whether the insured is a group (business) or an individual,
• The amount of coverages purchased (Accident, Hospital, Cancer, Disability, etc.), and;
• The limits for each of coverage (the amount that gets paid to you), which will vary per coverage, but usually range somewhere between $1,000 – $20,000.

Given these variables, it is typical to see each coverage in the $20-40/month range. Here are some tables showing approximate cost ranges for a variety of business sizes and coverages purchased.

Here’s a cost range with one coverage:

Here’s a cost range with two coverages:

Here’s a cost range with three coverages:

How Do I Find Out More?

If any of this sounds interesting to you, and you want to know more about Supplemental Health Insurance for yourself or your business, here’s how! Our process is remarkably simple:

1. Set up a time to talk. Just click on the “Request a Quote” button below.
2. Have a conversation. We’ll learn about you and your business, gathering all the information needed to offer you a quote.
3. We’ll present you with a plan. Once we’ve received your custom offer, we’ll reach out to you and schedule a time to discuss and review your no-pressure potential Supplemental Health Insurance solution.