health insurance

Innovation and improvements 

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

June marked my eighteenth year in the insurance industry; my entire career has been focused on employee benefits and helping clients save money and improve employee confidence in benefits. When I was asked to join the WisMed Assure team, I was given the chance to be innovative and truly build something the way I felt it should be and that’s exactly what my team and I are doing!

When I was hired in 2016, I was asked to help strengthen our employee benefits programs and services. At that time, we did not offer many services, nor did we provide a lot of in-depth consulting regarding health insurance. Now we have launched a new pooled Dental insurance plan with Delta Dental of Wisconsin, a pooled disability plan, an association health plan with WPS and The Alliance and added a dozen new services and assessments. We continue to add services and programs to provide the best coverage for our clients.

I am very excited to announce our next innovation. WisMed Assure will be adding a second Association Health Plan eligible for all health care companies in the Madison/Dane County area. Our new Association Health Plan will offer Group Health Cooperative (GHC) of South-Central Wisconsin as the insurance carrier, providing access to GHC clinics and all the UW Health clinics in Dane County plus UW hospital. This benefit offering will be available starting on September 1, 2023. We are proud to have an additional plan option that will better serve our clients in Dane County and surrounding areas.

This option provides HMO rates to our members and those of the health care community. If you’ve ever thought, “We’re a low utilizing group, we don’t really use our health care,” this is a great opportunity to explore. These plans are medically underwritten and can provide a glimpse into your company’s utilization.

If you would like to see how our rates look, please email me at chris.noffke@wismedassure.org or call 608.442.3734. Wishing you the best of your remaining summer!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

WisMed Assure can assist you with your Medicare decisions

By Mary Krueger, Medicare Specialist

Many Medicare eligible participants are familiar with Medicare, but the process is confusing to them so we’re here to assist you with those issues. Here are the answers to some common questions.

Do I need to sign up for both Part A and B or just Part A? 

Whether you choose Part A, B or both depends on the plan you’re on, the benefits you’re looking for and if you have any spend down accounts that can be used. Checking all your options will save you money and find the coverage that suits your needs.

Is it really necessary to get a prescription drug program or can I skip it because I don’t use any prescriptions?

Great question! Even if you do not use any prescriptions, you are required to obtain credible coverage for prescription coverage. Without it, you will acquire a lifetime penalty.

I am already on a Medicare program. Is there any help you can give me?

Yes! We compare your coverages and costs. Perhaps you’ve moved and your new address has a favorable discount or you have increased needs for prescriptions; these issues and others are addressed either during your open enrollment period each fall or at your renewal. We do the shopping for you!

Click here to learn about income related monthly adjustment amount (IRMAA).

For help with your Medicare questions, contact Mary Krueger at 715.760.1350 or mary.krueger@wismedassure.org.

Winter 2023 Issue

Long-term care insurance – but what if I don’t need it?

By Tom Strangstalien, Insurance Advisor

We all know the risks of a long-term care event devastating our family’s finances as well as our mental and personal well-being. Roughly half of those who reach the age of 65 will require some form of long-term care assistance during their lifetime.

Read more…


Rising health insurance premiums

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Health insurance premiums are constantly on the rise. According to the Centers for Medicare & Medicaid Services, “U.S. health care spending grew 2.7 percent in 2021, reaching $4.3 trillion or $12,914 per person.” Everyone from employees to employers are feeling the squeeze of high-cost premiums.

Read more…


Exercise your financial muscles to get financially fit

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

“Those who work their land will have abundant food, but those who chase fantasies have no sense.” This ancient advice from Proverbs illustrates the importance of financial fitness.

Read More…


Medicare questions to ask

By Mary Krueger, Medicare Specialist

Before enrolling in Medicare, there are several decisions Medicare recipients need to make regarding their existing coverages or changes in their health insurance needs.

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Small business claims that can be surprisingly expensive

By Society Insurance Human Resources, reposted with permission from Society Insurance

While running a small business, there’s a decent chance that throughout its course you’ll have to file some sort of insurance claim (often unexpectedly). Whether due to fire, theft, on-site injury or other incident, some experts estimate that 75% of small businesses faced an insurance-worthy incident just last year.

Read more…


Medicare questions to ask

By Mary Krueger, Medicare Specialist

Before enrolling in Medicare, there are several decisions Medicare recipients need to make regarding their existing coverages or changes in their health insurance needs.

Typically, six months prior to becoming eligible (eligibility for Medicare may be because of disability or turning 65), it is a good idea to speak with a Medicare Specialist to establish an open dialog about what you want in your benefits and how much of your budget to designate for it.

Here are a few questions:

  • Will I be in a network or have the freedom to choose where I go?
  • What are the benefits of choosing a Medicare Advantage or a Medicare Supplement?
  • Who will help me if I have a claim and don’t understand the billing?
  • Will I need to get preauthorization for my surgery?

These are a few of the concerns that are voiced regularly. Medicare has been providing coverage since 1965. Plans have changed over the years and so have the benefits, which is why it makes sense to have someone who can walk you through these and many other issues with Medicare.

I have enjoyed helping in those decisions for more than 40 years, and it is my pleasure to assist in the decisions Medicare recipients make. Contact me at 715.760.1350 or mary.krueger@wismedassure.org.

Rising health insurance premiums

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

Health insurance premiums are constantly on the rise. According to the Centers for Medicare & Medicaid Services, “U.S. health care spending grew 2.7 percent in 2021, reaching $4.3 trillion or $12,914 per person.” Everyone from employees to employers are feeling the squeeze of high-cost premiums. As rising premiums keep employers frustrated, benefits-users are also enduring less and less being paid by insurance. Business owners are having to make decisions like sacrificing benefits to save money on premiums to afford higher wages. Many employers are asking if they should self-fund. 

Having a really big company with lots of the employees covered by the health plan means these employers have more money being paid into the premium pools – the basic rule of large numbers. In Wisconsin, any group with more than 50 employees is considered a large group and is not qualified for the Affordable Care Act marketplace plans. While companies with as few employees as 50 may qualify for a self-funded benefit, it could also be a liability that causes a business bankruptcy. An employer can hedge their premium dollars against only having a few high-cost health care claims per year. These same strategies don’t work for smaller companies, because they may not have many employees enrolled in the health plan (especially if the employer contributions are too low) which means they have even fewer premium dollars to cover when their work family does have a high-cost claimant(s).

For example, if a smaller group (50 employees for this scenario) has a high-cost claimant who costs $50,000 a year, that means a lot of your collected premiums are needed just to cover this one claimant. Assuming an average employee premium of $1,000 a month per employee (averaging employee and family), your employer premiums are $50,000 a month ($600,000 a year). That means one employee used one-twelfth of your premium funds.

In our example we have only covered $50,000 in claims and we still have 49 remaining insureds who may each spend the $12,914 average. The math, 49 persons at $12,000 means $588,000 potential you may have to pay. This is not yet taking into account that there are multiple people in your employee’s families who may have claims.

It is not just claims you pay for when you are self-funded, you are also responsible to pay for a selected insurance company or third party administer (TPA) to process your groups’ claims, your use of a network for discounts, a pharmacy benefit manager, stop loss insurance, Patient-Centered Outcomes Research Institute (PCORI), terminal liabilities, aggregate accommodations and other administrative costs just to name a few.  This all may not make sense yet or it might sound like another language. Just let me know and we can talk. Give me a call at 608.442.3734. While true self-funding may not be the best answer for your company, utilizing strategies, other funding arrangements and even our association health plan may be a solution.

Fall 2022 Issue

Affordability testing

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

The Affordable Care Act (ACA) brought a lot of extra work to employers and insurance companies. Whether you are pro-health care reform or against it, per the Health Affairs article, the ACA has not made insurance more affordable.

Read more…


Don’t forget to call your mom – and your insurance agent

By WisMed Assure Service Team

With the intention of easing administrative burden for WisMed Assure client physicians, several of our Medical Professional Liability carriers have significantly reduced or suspended asking for renewal applications over the past few years. While this does save time, renewal applications were an opportunity to touch base, review and discuss any changes to your practice that could impact your premium or coverage.

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Year-end tax planning for 2022

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

Want to put thousands of dollars back into your pocket? Who doesn’t. Choices you make during your employer’s open enrollment period and for year-end tax planning can really add up.

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Graded premium disability? Yes, you can!

By Tom Strangstalien, Insurance Advisor

I recently worked with a young physician to set him up with personal disability protection to provide some financial security if life throws him and his family a curve ball. Prompting our planning was that one of his peers in the general surgery specialty sustained a serious hand injury, ending his ability to perform hands-on surgery.

Read more…


5 ways to develop inclusive hiring practices

By Society Insurance Human Resources, reposted with permission from Society Insurance

Inclusive hiring practices recognize diversity and embrace a wide range of perspectives that candidates from all walks of life bring to the organization. And according to research from Monster, “Four in five (86%) candidates globally say diversity, equity and inclusion in the workplace is important to them.”

Read more…


Affordability Testing

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

The Affordable Care Act (ACA) brought a lot of extra work to employers and insurance companies. Whether you are pro-health care reform or against it, per the Health Affairs article, the ACA has not made insurance more affordable. Many health insurance carriers have stated the ACA, Summaries of Benefits and Coverage, machine readable files and other changes imposed added costs to insurance companies, which simply passed these costs on to employers and employees in premiums.

Insurance premium affordability is very important because it allows for more money to employers and employees and is a requirement for groups with 50 or more employees. As you may know, health care reform requires employers with 50 or more employees to offer a group health insurance option that is affordable and meets the minimal essential coverages or the employer can face a potential monetary fine (the 2022 fine was $4,120 annually per subsidized employee). Additionally, the employer should be testing to confirm the affordability requirement is being met for their employees’ premium charges. Based on health care reform’s 2023 rules, to be considered affordable in 2023, an employee cannot be charged more than 9.12% of the employee’s household income.

Do you need to test your affordability? Are you offering a plan similar to other health care companies in your areas? WisMed Assure is the only insurance agency in Wisconsin focused on health care clients and we would love to tell you more about what we can do! Please call me at 608.442.3734 or email chris.noffke@wismedassure.org.

Your life has only 3 planning scenarios

Mark Ziety

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

You’ll either have a long life, health problems along the way or a short life. That’s it.

Plan for those three situations whether you’re single, married, with or without kids and most of your planning is done. Let’s look at how to plan for each.

First, essential tasks for everyone

  • Manage monthly cash flow. Call it a budget, spending plan, living below your means or whatever makes it appealing to you. It doesn’t matter if you have high income or low income, everyone needs to control their inflow and outflow.
  • Life happens, have an emergency fund.
  • Pay off all high interest consumer debt.
  • Give of your time, resources and be thankful. Live happy.

Plan for a long life

  • Are you saving at least 15% for retirement with the right investments? Boosting it to 20-25% is even better.
  • Have you maximized your tax advantaged retirement accounts through your employer and on your own?
  • Will your tax burden be higher or lower in the future? Hint – if you have a lot of tax deferred investments, you could be igniting a tax bomb that hits later in life.
  • Save for kids’ education expenses.
  • Determine the monthly income you’ll have in retirement from all sources.
  • Dream about your future.

Plan for health problems

  • Health insurance is the obvious answer.
  • Auto and umbrella insurance can provide for you via uninsured/underinsured coverage.
  • Disability insurance that replaces two-thirds of your income if you can’t perform your own occupation is critical, especially during your early and mid-career. A policy with an inflation adjustment is even better.
  • Everyone over age 18 should have health care and financial power of attorney documents.
  • Do you have a source to pay for long-term care expenses? If not, consider an insurance policy.

 Plan for a short life

  • If anyone depends on you for income, get term life insurance. It’s cheap, so don’t skimp.
  • Are your beneficiary designations correct?
  • Do you need a will or trust?
  • Ensure your family knows where to find your documents and accounts.
  • Tell your family you love them. And if you’re faithful, pray.

Since we don’t know the future, all three plans are important for everyone. Our Physician’s Financial Guide has even more tips. Or, for one-on-one help schedule an appointment.

To your best life and healthy finances.

Mark Ziety, CFP®, AIF® 608.442.3750.
WisMed Financial, Inc. part of the Wisconsin Medical Society