Health Insurance Terms

MHG Insurance strives to provide our clients with the best service and the most viable information regarding insurance policies and services currently available on the market. We want our clients to be able to make informed decisions about their healthcare, as well as become familiar with what their own insurance needs are. This can be a challenging task, however, as the insurance industry has practically established its very own language which includes a myriad of terms and confusing industry related jargon.

Below are commonly used health insurance terms, clearly defined to make it easier for you to apply this information when you review your current policy, or when you are considering making changes to your existing plan. As always, MHG is available at any time to discuss any questions you may have regarding your existing plan, or to examine these terms in more depth:

  • Deductible: A deductible is a fixed dollar amount during the benefit period, usually a year, which an insured person pays before the insurer begins to make payments for covered medical services. Plans may have individual and family deductibles. Some plans may have separate deductibles for specific services, such as a deductible for each hospitalization admission.

  • Coinsurance: A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible (if any) has been paid. Once the deductible and/or coinsurance have been paid, the insurer is responsible for the rest of the reimbursement for covered benefits.

  • Copay: A form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is then responsible for the rest of the reimbursement.

  • Out of Pocket Maximum: This is the maximum dollar amount a group member (the insured) is required to pay out of pocket during a benefit year.  Until the maximum is met, the plan and group member share in the cost of covered expenses.

  • In/Out of Network or Participating Provider: Your health plan contracts with a wide range of participating doctors, specialists, hospitals, pharmacies, and labs. These providers have agreed to accept your plan’s contracted rate as payment in full for services. The contracted rate includes both your insurer’s and your share (deductible, copay, coinsurance) of the cost. For those with out of network benefits, services from a provider who is outside of this network are not based on agreed upon or set contracted rates with your insurer, and therefore the services may be subject to higher charges. This may result in you paying more out of pocket for the difference owed between what the provider is charging and what your plan will cover.

  • HMO : HMO stands for Health Maintenance Organization. It is defined as a health care system that assumes both the financial risks associated with providing comprehensive medical services (insurance and service risk) and the responsibility for health care delivery in a particular geographic area to HMO members, usually in return for a fixed, prepaid fee. Financial risk may be shared with the providers participating in the HMO. There are different types of HMOs, including a Group Model HMO which contracts with a single multi-specialty medical group that provides coverage to the HMO’s membership. There is a Staff Model HMO where patients can receive services only through a limited number of providers, in which physicians are employees of the HMO, usually operating within the HMO’s own facilities. There is also a Network Model HMO that contracts with multiple physician groups to provide services to HMO members. Finally, an Individual Practice Association HMO is a type of health care provider organization composed of a group of independent practicing physicians who maintain their own offices and band together for the purpose of contracting their services to HMO’s.

  • POS: A POS plan is an HMO/PPO hybrid; sometimes referred to as an open-ended HMO when offered by an HMO. POS plans resemble HMOs for in-network services. Services received outside of the network are usually reimbursed based on a fee schedule, or what is considered to be reasonable and customary charges.

  • PPO: A PPO plan is an indemnity plan where coverage is provided to participants through a network of selected health care providers, such as hospitals and physicians. The enrollees may go outside of the network for services, but would incur larger costs in the form of deductibles, higher coinsurance rates, or non-discounted charges from the providers.

  • COBRA: COBRA stands for the landmark Consolidated Budget Reconciliation Act of 1986. This law provides the continuation of group health coverage that would otherwise be terminated for a former employee, retirees, spouse’s former spouses and dependent children. The coverage is available when coverage is lost due to certain specific events, such as voluntary or involuntary termination of employment, reduction of the number of hours worked by the employee, covered employees becoming entitled to Medicare, or divorce or death of a covered employee. However, in most cases, the insured person must continue to pay his or her portion of the insurance premium as well as the portion that was previously being paid by the employer in order to maintain coverage.

MHG Insurance wants you to understand health insurance terminology that can often be confusing and overwhelming. We welcome your feedback and any questions you may have. You may contact MHG at 954-828-1819, or by visiting us at mhginsurance.com.  Here’s to your good health!

Commonly Used Health Insurance Terms

Reasons to Buy Life Insurance

No one wants to think about the unforeseen loss of a spouse or loved one.  Just the thought of losing someone you love brings up unpleasant, emotional feelings. However, taking the time and making a small investment to plan for such an event – whether it be that of your own passing or that of a spouse - is not only necessary, but it is one of the most generous, loving gestures you can make for those you love. Here are the ten reasons why everyone should consider purchasing life insurance :    

  1. Protect those you love. Your loved ones will be able to go on financially and without the stress and worry of how they’re going to pay the bills. Your children’s future will be solidified, allowing them to attend college, while your spouse will have the means to continue paying the mortgage and stay in your family’s home.

  2. Peace of mind. Are you the top income earner in your household? When you obtain life insurance, you will no longer have to worry what will happen to your family in the event of your death or if you become terminally ill – at which time life insurance becomes practically impossible to acquire.

  3. Life insurance creates options. Often, when a loved one who was the top income provider of the family passes, survivors are forced to make quick, important financial decisions during a very tough, emotionally charged time.

  4. Life insurance has more than one purpose. Your policy is a valuable asset that can provide a specified sum of money at a time when it is needed most. You can choose a Life insurance plan that is an annuity – which will actually supplement your retirement income with a guaranteed monthly stream of income once you retire for as long as you live.

  5. You never know what can happen. In the event of an emergency or abrupt onset of terminal illness, you may be able to request a withdrawal or loan from your policy for a much needed cash infusion to keep your household running smoothly.

  6. Death shouldn’t equal debt. Debt can be a tremendous burden for anyone, but it is especially difficult to deal with for those who are grief stricken.

  7. Take care of your business. Life insurance doesn’t just protect individuals. It can protect a business from financial loss, liabilities, or instability in the event of the death of a business owner or partner.  It can be invaluable in providing an infusion of cash to keep operations going until things settle down.

  8. Funerals are expensive. A funeral can cost anywhere from $7,000 to $10,000 – and that is just for an average, “no-frills” burial. Life insurance can cover this cost without further financial hardship and stress for your loved ones.

  9. It makes financial sense. Life insurance is considered a financial asset, which can help increase your credit and help you get a loan or health insurance.

  10. Give to charity. Life insurance will allow you to leave a meaningful gift to a favorite cause or charity that is larger than you would have been able to set aside for a donation.

Obtaining life insurance ensures financial stability for those left behind in the event of an unforeseen tragedy, as well as providing cash in times of need. Contact MHG Insurance Brokers to learn more about obtaining life insurance and the different types of policies available by calling 954-828-1819, or visiting online at mhginsurance.com . Let us help you begin the preparations today to protect the ones you love most.

Top Ten Reasons to Buy Life Insurance

Regulatory Changes Affect Captains And Crew

It is often said that, “The only constant in life is change.” This statement could not be more appropriate with the changes that are happening regarding health insurance and the superyacht industry. Between Health Care Reform and the Maritime Labour Convention , 2006 (MLC) coming into effect soon, now is the time for yacht captains and crew to learn about regulatory changes taking place and how they can best protect themselves.

Mark Bononi, MHG Insurance Brokers’ Yacht Division Director, is featured in this month’s issue of Dockwalk, the premier magazine for superyacht captains and crew. He speaks candidly about this specific issue and offers pertinent advice for those in the industry. For starters, let us begin with the MLC, which will be going into effect on August 20, 2013. If you have assumed the MLC will make the vessel owner responsible to take care of all your health and medical insurance needs, this is simply not the case. 

The MLC is basically designed as a minimum standard for the commercial shipping world and does not mean individual yacht crewmembers will be adequately protected. Bononi shares that the MLC going into effect really does not change much regarding coverage. He explains that the “MLC states that each vessel owner is liable for crew medical costs.” However, the MLC does not spell this out clearly, stating the yacht owner must provide “financial security” to cover death, repatriation or long-term disability costs. Bononi then asks, how will this “financial security” be proven? It will most likely be subject to interpretation by each individual port state inspector. Proof might come in the form of providing health insurance, or having money in an escrow account, or in another manner…either way, it is not clearly stated. 

In addition, many insurance policies offered by a yacht owner do not include all-encompassing health care for yacht crewmembers. Bononi stresses the point that this is where the responsibility ultimately falls on the crewmember to make sure their medical and health insurance needs are met, and how a separate medical policy can offer added protection and peace of mind. When it comes to Health Care Reform, Americans who work as yacht crewmembers are currently playing the waiting game. Do not assume that not residing in the U.S. the majority of the year removes your requirement to pay for health insurance or be subject to a tax. Currently, the rules around residency and time periods for residing outside of the U.S. are vague at best. This makes it difficult for yacht crewmembers to plan for their health insurance needs. 

Staying in contact with an experienced yacht insurance broker, such as MHG, is imperative, as they will keep abreast of all regulatory changes that are happening regarding the MLC and Health Care Reform. Bononi states that it really boils down to each individual crew member getting adequate coverage for themselves that meets their specific needs, even if this comes in the form of an additional policy over what the yacht owner provides. 

His other important piece of advice is not to wait: “Health insurance only gets more expensive the older you get, so getting on board early with a comprehensive health policy can help with future costs.” Bononi’s full interview is available in the August issue of Dockwalk magazine. 

If you are a yacht crewmember seeking to learn more about health insurance options available to you, call MHG today and let a skilled representative explain more regarding the MLC and Health Care Reform. MHG Insurance can also provide you with numerous quotes from top-rated insurance companies who offer policies that meet your budget and individual needs. Call MHG today at 954-828-1819 or learn more by visiting mhginsurance.com

How Upcoming Regulatory Changes Might Affect Captains and Crew

Urgent care and walk-in clinics

1) What are walk-in clinics/urgent care centers?


If you are faced with a non-life threatening illness or mild injury, an urgent care center or walk-in clinic can offer you medical attention in the event your primary care physician is not available and/or when a trip to the emergency room may not be necessary. Many urgent care clinics are often open after hours, seven days a week and appointments are not necessary.  

2) Choosing a walk-in clinic/urgent care center 

There are more than 8,000 urgent care clinics in the United States. Choosing a center often comes down to proximity, insurance and quality of care. You want to choose a center that is near your home or work and can offer you quality care and assistance in a reasonable amount of time. Consider this list of factors when choosing an urgent care center:

Location: Is the urgent care center a reasonable distance from your home, school or office?

Availability: What hours is the urgent care center open? Many walk-in clinics are not open 24 hours, however they commonly accommodate after hours, weekends and holidays. It is advisable to call ahead to confirm hours of operation and ensure it fits your schedule.

Insurance: Does the clinic accept your individual health insurance plan or group health insurance plans? Many clinics accept most insurance plans. If you do not have insurance, the clinic will assist you, but there is an upfront charge required.  

Quality: Is it too crowded? Were you treated kindly? Did you receive adequate care? These questions can be difficult to answer before you visit a clinic, but if you do not receive quality care, you should report the mishap and find another clinic for future needs.  

Recommendations: Ask a friend or relative about their experiences at local urgent care centers. Quality is easier to measure when you can learn from someone else’s experience.  

3) When to use urgent care centers/walk-in clinics 

Emergency room wait times are often high and should be reserved for emergency use only. Urgent care centers are designed to free up emergency rooms for true emergencies. Severe accidents, deadly illness, bleeding wounds and similar incidences are for the emergency room, but basic illnesses, such as a cold, the flu, a cough and even a fever can be treated at an urgent care center. 

Basic injuries such as bruising, sprains or possible minor broken bones can also be diagnosed at an urgent care center, where they may send you onto a hospital depending on the degree of injury.   Walk-in clinics offer you fast, quality medical care and, in most cases, for a lot less money than the ER. This is why it is important to be aware of your ER alternatives before you need them.

Urgent care and walk-in clinics

The experts say if you do something every day for 30 days it will become a habit. Summertime is the perfect time to develop healthy habits that can create positive lifestyle changes.  


For a healthy lifestyle one needs to eat healthy, be active, protect yourself and your family, manage stress and get regular checkups by your doctor. Eating healthy is an easy habit to develop in the summer with the variety of fresh fruits and vegetables that are available.  Stop by a farmer’s market and try some  of the amazing fruit that is in season right now. Make sure you eat a variety of fruits and vegetables each day and include some whole grains.

Limit foods and drinks high in calories, sugar, salt, fat, and alcohol. A balanced diet combined with physical activity will help keep you at a healthy weight. Children and teens need to be active for at least one hour a day and outdoor activities are plentiful this time of year.  Include activities that raise their breathing and heart rates and that strengthen their muscles and bones. Adults should be active for at least 2½ hours a week. You should also include activities that raise your breathing and heart rates and that strengthen your muscles. With the long summer days there are plenty hours of sunlight to get moving in.  

Physical activity helps to maintain your weight, reduces high blood pressure, heart attack, stroke, and several forms of cancer. Arthritis pain, depression and anxiety symptoms are also reduced by physical activity. When out enjoying the summer days remember to wear sunscreen and insect repellent.  Protect yourself and your family from injuries with seat belts, helmets, and protective sports equipment. Eating right and daily exercise will help manage stress.  

Remember to balance work, home, and play.  Everyone needs a support group of family and friends. Relaxation and meditation are great stress relievers, take time for yourself.  And strive for 7-9 hours of sleep each night, children including teenagers need even more sleep.  If you are still feeling over whelmed or depressed counseling may be needed. 

Remember to schedule regular checkups for you and your family with your doctors.  Discuss your health problems and risks and devise a plan for improvement.  Find out what exams, tests, and shots you need and when to get them.

A little prevention goes a long way to help ensure a long and healthy life. Check with your broker to see if your health benefits plan covers for those regular checkups, tests, and shots. It is important that you know your coverage before you need it. MHG your Marine Insurance Broker offers a variety of comprehensive medical insurance plans to meet the needs of each unique client. 

Whether you are looking for specialty marine crew insurance , individual health insurance plans, family health insurance plans , or group health insurance plans, the experts at MHG Insurance have the resources to help you choose the ideal policy for your unique requirements. Contact us today at 877-278-7400 to learn more.  

Healthy Living Tips From Your Marine Insurance Broker

At MHG Insurance Brokers we specialize in insurance plans designed specifically to meet the needs of marine employers, shipboard officers and crew, and contractors and concessionaires.  Because of the unique needs of individuals and groups at sea, choosing an insurance broker that understands the lifestyle and work environment is essential. 


Services offered by MHG can be tailored according to each employer’s needs with the secure knowledge that they are marine specific and supported by a team experienced in the marine environment. With our extensive market relationships and experience in the industry, we offer sound, independent advice as to which insurance and financial services providers and products are best suited to address the needs of individuals and employers.

Marine insurance solutions include private international health insurance, vacation health insurance, disability income, life insurance, short-term health insurance and retirement savings plans. Here is more information on the plans we offer.

MHG provides private international health insurance to all nationalities. Our extensive market relationships permit the design of international group medical plans that are tailored to each employer's specific philosophy and compensation needs. MHG also offers various benefit packages that can be combined for groups located in the US.

MHG offers short-term health insurance for contractors and concessionaires which provides coverage for emergency medical treatment, emergency medical evacuation, should the local facilities be inadequate and a number of other benefits. For groups requiring coverage for employees while on vacation, we can customize a plan to fit your needs.

Disability Income is an effective risk management tool for employers that not only enhances the value of compensation packages for employees but also provides peace of mind.  It can provide protection against loss of income in the event an employee becomes temporarily or permanently disabled while at work or on vacation. Coverage is available to groups of five or more and can be customized to fit your budget and benefit needs. With worldwide coverage for disability due to accident or sickness, these plans also allow you to select a waiting period and benefit amount while typically not requiring underwriting.

Let MHG Insurance Brokers provide you and your employees with peace of mind.  Group life insurance offers employees comfort knowing that in the event of their death their loved ones will receive financial support for ongoing expenses, funeral arrangements or children's education. For employers, group life insurance is a cost-efficient benefit because it is highly valued by employees.

MHG's investment team is able to provide cost effective, flexible benefit retirement savings plans which will help recruit, retain and motivate staff while providing the employer with maximum value for each dollar spent. As your specialist plan manager, MHG's role would normally involve consultancy, plan design, independent brokerage, investment planning and communication, installation and administration of the plan. We also provide consultancy and plan management services for employers with existing plans.

With over 20 years of experience focused on the welfare of crew, MHG has the knowledge to advise the cruise industry about its insurance needs.  Please contact us today at +1 954 828 1819 for more information on any of the services we provide.

If you are attending Cruise Shipping Miami March 13th-15th at the Miami Beach Convention Center, please feel free to stop by our booth #1893 located in the Ship Services and Hotel Operations section. Join us for a glass of wine during our reception on Wednesday, March 14th from 2pm-5pm.  If you still need tickets for Cruise Shipping Miami, avoid the $100 fee and register as our guest for complimentary tickets to the Exhibition Hall.

MHG – The Cruise Industry’s Insurance Specialists

The only constant in life is change. You’ve heard it and are intimately familiar with the dynamic quality of life. Whether you’re starting a family, going on a trip to a foreign country or moving to a new city, life’s milestones can also put you at risk of being underinsured. 


Although insurance can be confusing and overwhelming, it’s important not to dismiss the responsibility of understanding your coverage and when and why you need it. Instead of tackling this task on your own, the best way to ensure that your insurance coverage is keeping up with the events in your life is through periodic reviews with your insurance provider. Adequate coverage is essential to your financial security, and without it, you could be unwittingly putting your hard-earned money at risk. 

MHG clients are fortunate to have access to knowledgeable insurance representatives to help translate the convoluted to comprehensible, helping to make sure that the things that matter most are protected. Our reps offer round-the-clock support – whether you’re curious about the benefits of life insurance, are wondering whether or not you need commercial insurance or need to understand your health insurance co-pay policy, MHG is always just a phone call or email away.

All MHG clients receive this free service from our experienced, credentialed professionals. We are committed to helping you map out your financial future as a full-service insurance provider. 

Remember, MHG’s 24/7 service comes free of charge, but the peace of mind that comes with knowing that you took the time and action to protect your family and belongings is invaluable. MHG Insurance Brokers has set up phone numbers around the world for your convenience. We welcome you to call us any time to learn more. 

The Right Amount of Coverage for Every Stage of Life