PCSA is proud to introduce a new insurance program for its members. We realize that health insurance for small businesses and self-employed individuals can present challenges, both in terms of accessibility and affordability. Our new program includes:

• Large selection of health insurance plans and companies
• Dental, Life Insurance, Disability, Cancer, Accident, Critical Illness, Vision and Long-Term Care Insurance
• Consumer information about the various types of health plans (PPO’s, HSA’s, HMO’s, etc), including the pros and cons of each type of plan
• For those of you with employees, our program provides guidance on employer-sponsored health care plans, including contribution rules, participation requirements, COBRA, HIPAA and more
• Information to help you understand and manage specific medical conditions and health issues
• Valuable information on wellness, prevention and disease management
• Resources for the uninsured and those with uninsurable medical conditions

Unfortunately, most national associations, including PCSA, are not able to offer true group coverage for their members due to legal restrictions. Although federal legislation allowing association group plans has been proposed in Congress many times, it has never made it through the legislative process for approval. Until such a law passes we must work within the state controlled regulatory framework that governs personal and small business health insurance. Each state is responsible for regulating its own insurance markets, and the result is that plan availability, rates and underwriting rules vary greatly from state to state. Therefore, our health insurance program also varies in availability, rates and underwriting from state to state.

WorldWide Insurance Services, Inc., a national, independent broker, in business since 1989, and representing more than fifty insurance companies, administers our program.

Following are frequently asked questions and answers about our health insurance program:

Q. Which insurance companies are offered in the program?

A. The state in which you live determines the insurance companies that are available. Your proposals will include quotes from several of the best companies available in your area. Major insurance companies included in the program are Aetna, Anthem, Assurant Health, BlueCross BlueShield, Golden Rule (a UnitedHealthcare company), Guardian, Health Net, Humana, John Alden, Time Insurance, UniCare, UnitedHealthcare and many other regional companies.

Q. Which types of insurance plans are available?

A. In the majority of states we offer PPO, POS, HMO, HSA and traditional major medical plans. Also included are student plans, children-only plans, and temporary health insurance plans for those with gaps in coverage. WorldWide’s representatives can provide detailed explanations of the features, benefits, limitations and exclusions of each type of plan in the program.

Q. Are your rates lower than the rates that I would pay if I went directly to these insurance companies?

A. As we mentioned, health insurance is regulated by each of the states. This regulation includes oversight on rates, which must be filed by the insurance companies with the state, prior to the sale of any policies. Currently the states do not allow discounting of rates. Our program more closely resembles a shopping service for our members, in some cases offering as many as 500 different plan designs to our members. However, unlike health insurance rates, our dental, vision, accident and cancer plans provide discounts for our members, their families and employees and are available in nearly all areas.

Q. Is the program available in every state?

A. There are a number of states in which the program is not available. In such states, WorldWide provides our members with a list of carriers, including contact information, that are available in their states.

Q. Is acceptance guaranteed?

A. For individual members, or members who are insuring themselves or their families (not their employees), coverage is not guaranteed except in a small number of states, primarily in the Northeast. In most states, members will be required to complete medical questionnaires in order to determine whether they qualify for coverage. For those members insuring themselves plus 1 to 49 other employees, coverage is guaranteed, under federal law, in most states (several states guarantee coverage to groups of one).

For those individuals with medical conditions that are uninsurable, WorldWide’s representatives will provide information and contacts for each state’s risk sharing pool plans or for their state’s designated carrier offering open enrollment.

Q. What about pre-existing conditions? Are they covered?

A. The answer to this question varies greatly and depends on several factors, including the severity of the condition, prior coverage, which type of plan is being applied for, and the state in which you reside. WorldWide’s licensed representatives are trained to take a detailed medical history before releasing quotes for which you may or may not qualify. They also have direct access to underwriters so that they can determine if you qualify, even before completing an application for coverage.

Q. With all the plans to choose, how can I tell which plan is right for me?

A. WorldWide’s representatives will work with you to learn about your medical situation, frequency of doctor visits, your medications, and preferred doctors and hospitals. They will identify plans that meet your objectives that are also within a budget that you can comfortably afford.

Q. Must I purchase my plan through the program or can I use my own broker or buy direct?

A. The choice is yours. You can make your purchase through WorldWide, or through your local broker, or, in some cases directly from the insurance company. Regardless of whom you purchase your plan from, WorldWide provides its information free of charge and you will pay the same amount for your coverage regardless of who it is purchased through.

Q. How much does the shopping service cost?

A. There is no charge for this service.

Q. How can I get involved in order to assure the passage of a national association health insurance bill?

A. While various association health insurance bills have passed the House of Representatives many times (seven at last count), a bill has never passed a Senate committee and made it to the Senate floor for a vote. We suggest that you write your senators and urge passage of such a bill. WorldWide’s representatives can provide suggested wording for a letter or e-mail, and they can also provide contact information for your state’s senators.

For information and rate quotes call WorldWide Insurance Services, Inc. at 800-955-0418,
or send an e-mail inquiry to info@wwins.com.