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Jason Ross Insurance Agency is a full service company dedicated to finding you the best coverage for the lowest price. We pride ourselves on our ability to research our clients' individual needs, and to introduce insurance policies that are tailored specifically to reach a maximum level of benefits without costing a fortune.

Health Insurance - Life Insurance - Group Health Insurance

We invite you to be in control of your health care costs by allowing us to audit your coverage. Nine times out of 10, we are able to assist our clients in the acquisition of more favorable coverage for less money. This comes from really listening to what our clients tell us about what they want from health care.

What is Coinsurance?

Many major medical plans have an initial deductible, which is a set amount you pay for services such as hospitalizations. After you satisfy your deductible, many plans will pay a split portion of your bill. For example, if you have a plan with 20% coinsurance, then the amount of money that is owed to the hospital or doctors will be split, with the insurance company paying 80% and you paying 20%. But the good news is that you will not pay anything above your Annual Out of Pocket Maximum (OOP Max).

What is an Annual Out of Pocket Maximum?

The Annual Out of Pocket Maximum is the absolute total you must pay out of your own pocket before your major medical insurance policy will pay 100% of all covered charges for your medical care.

Let's look at this example:

You have a plan with a $2500 deductible, 25% coinsurance, and an Out of Pocket Maximum of $7500.

You break your leg in an accidental fall, and are taken to the hospital. The doctors fix your leg and bill your insurance for the total which happens to be $4800.

In this case, you would pay the first $2500 (your deductible) and the remaining $2300 would be split between you and your insurance company with you paying 25% of the remaining $2300 and your insurance company paying 75% of the remaining $2300.

Your total outlay in this case would be:

$2500 deductible

$575 coinsurance (25% of the remaining $2300)

Total = $3075 out of your pocket.

Now, lets look at the same coverage plan but with a much higher medical bill. Let's suppose you had heart troubles, a stroke, a kidney transplant or any given major event and the total between the doctors and hospital was $162,000!

In this case you would pay the first $2500 (your deductible), and the remaining $159,500 would be split between you and your insurance company with you paying 25% and your insurance company paying 75%. Remember, however, YOUR payments will NOT exceed your Out of Pocket Maximum.

Of the remaining $159,500 you would pay 25%, up to $5000. How can that be? Twenty-five percent of $159,500 is $39,875!

Yes that's true but remember your insurance plan has an Annual Out of Pocket Maximum. And this maximum is the most you will pay in a year for covered services before the insurance company will pay 100% of your bill.

Your total outlay in this case would be:

$2500 deductible

$5000 coinsurance (25% of the remaining $159,500 but never any higher than your Out of Pocket Maximum)

Total = $7500 out of your pocket

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Don't leave yourself or your employees in the dark about how their health plan works. For the amount of money everyone is paying for health insurance, it only makes sense that everyone knows how to take advantage of their benefits to the fullest capacity possible.

If you have an employee with a situation that simply isn't making any sense, and nobody at the insurance company is giving you any worthwhile answers, call us, and we will tackle the issue head on as if it was affecting someone in our own family. TRY US! You will quickly see what we mean!

Jason Ross Insurance Agency
888-414-5678
28420 Lewis Place

Agoura Hills CA 91301
sales@JasonRossInsurance.com

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Areas served by the Jason Ross Insurance Agency:

Los Angeles Group Health Insurance, Santa Monica Group Health Insurance, Culver City Group Health Insurance, Woodland Hills Group Health Insurance, Chatsworth Group Health Insurance, Northridge Group Health Insurance, Granada Hills Group Health Insurance, Simi Valley Group Health Insurance, Thousand Oaks Group Health Insurance, Tarzana Group Health Insurance, Van Nuys Group Health Insurance, Burbank Group Health Insurance, North Hollywood Group Health Insurance, Hollywood Group Health Insurance, Oxnard Group Health Insurance, Camarillo Group Health Insurance, Glendale Group Health Insurance, small group health insurance, employee benefits for small companies. California benefits broker, El Segundo Group Health Insurance, Beverly Hills Group Health Insurance, Pasadena Group Health Insurance, Santa Barbara Group Health Insurance, Ventura County Group Health Insurance, Los Angeles Benefits broker, Los Angeles group health plan. Encino Group Health Insurance.

Jason Ross Insurance Agency

Nationwide Toll Free Number: 888-414-5678