Reading a Drug Formulary Without Guessing
If you’re an employer or HR admin fielding questions from staff about prescription drug coverage, you’ve likely stared at a…
Tag: plan documents & claims
How Prior Authorization Usually Works on a Group Plan
If your doctor has recently ordered a specialty medication, MRI, surgical procedure, or other non-routine service, they may have mentioned…
In-Network vs Out-of-Network: Questions Before You Enroll
Open enrollment season is here, and you’ve narrowed your health plan options down to two that fit your monthly budget.…
Embedded vs Aggregate Deductibles for Families
You recently signed up for a new family health plan, and within the first two months, your spouse needs urgent…
Deductible vs Out-of-Pocket Maximum, Explained with a Worksheet
If you recently received your 2024 employer health benefits packet, you may have spotted two unfamiliar dollar amounts listed for…
How to Read a Summary of Benefits and Coverage
If you’ve just received a 4-page standard Summary of Benefits and Coverage (SBC) from your employer during open enrollment, or…