Explanation of Benefits and How to Understand

An Explanation of Benefits, commonly referred to as an EOB, is a statement from your health insurance company providing payment details for medical service(s) you recently received. The EOB explains what portion of services were paid by your insurance plan and what...

HIPAA

Health Insurance Portability and Accountability Act (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA) is legislation that provides data privacy and security provisions in order to safeguard medical information. It was created primarily to...

Community Rating

What does the term community rating mean as it applies to health insurance?Health insurance carriers have different methods for determining the cost of a health insurance policy.  The amount paid for health insurance coverage is referred to as a “premium.”  If a...

Essential Health Benefits

The U.S. Department of Health and Human Services (HHS) issued a list of frequently asked questions (FAQ) in order to clarify the rules pertaining to the essential health benefits.  The requirements for essential health benefits were included in the Patient Protection...

Health Protector Guard

The Affordable Care Act (ACA) has created instability in the individual market, which has resulted in a dramatic escalation of premiums and an exodus of carriers providing coverage.  The lack of carrier competition has reduced plan options and limited provider network...

The Benefit of Negotiated Rates

Texas health insurance policy holders receive a benefit every time they file a claim but are probably not aware that they are receiving the benefit.  The most common type of health insurance for individuals and families is classified as a HMO  or Health Maintenance...