When people have a medical insurance plan, they would naturally have thought of using the policy at the time of purchase. The problem is that many people find health insurance claims very complex and therefore hardly ever use the plan. On the other hand there are people who file health insurance claims without understanding the policy. Such claims often get rejected, leaving the policy holder angry. Understanding the policy terms and conditions is the key to both the problems. If people have the right policy, this would not be a problem at all. The right plan would not only have good benefits, but would also be easy to understand.

People just presume that the policy would cover all the treatments mentioned in an advertisement or something similar. The problem is that people do not remember that there are many variants of the same policy. This is where the difference and the problem arise. The benefits shown in the advertisement may pertain to one particular variant of a policy. When a person buys the plan, they seldom read the policy wordings of the variant bought. There are certain benefits which are applicable in one variant but not in all. People have to remember this point when filing health insurance claims.

The policy benefits also vary depending on a person’s own health. For instance, the number of pre-existing diseases would differ from one person to another. This means that while one illness is covered for an individual, another person may have to wait for the same to be covered.

A person should get the needed health insurance policy at a time when he or she has the least medical hassles. One does not always have the plan that they need. People get drawn to policies by the advertisements. The fact is that one should read the policy wordings of the plan to understand it well. However, understanding them is not always easy.

People sometimes do not realize that the same plan could have two separate variants that cover different benefits. One variant may cover a particular benefit while another simply will not. This is why people should know the difference between the variant benefits and cover amounts. Apollo Munich, a standalone health insurance company, provides customers with simple wordings and a straightforward claims process so that they can file health insurance claims easily. The company also provides customers with cashless hospitalization in more than 4000 network hospitals.

After months of hearing forecasts of big hikes in group health insurance rates, Keri Jenkins got a pleasant surprise. Easy To Insure ME has the answers.

Coverage costs for her company, the Norfolk-based ship agent and broker T. Parker Host, would increase by just 7.9 percent, despite new requirements under the national health care overhaul.

It was the company’s smallest rate bump since 2005.

“We were very pleased,” said Jenkins, who is T. Parker Host’s senior vice president for administration.

Many employers, like Jenkins, anticipated big changes as they developed insurance plans for the first time since the passage of the new health law.

For 2011, the law requires coverage for more people and, in many cases, mandates preventive services without extra charge to individuals – benefits that come with a price tag.

However, South Hampton Roads insurers, consultants and employers said the overhaul won’t increase rates more than 4 percent next year, largely because many plans already came close to meeting the requirements.

Overall, including other climbing expenses, local group health insurance costs are rising between 6 and 12 percent – a range comparable to recent years, they said.

For employees, that means more of the same.

“What we’ve seen is a trend where employers continue to offer less benefits and pass on more of the cost to the employees,” said John DeGruttola, senior vice president of sales and marketing for Optima Health, the insurance arm of Sentara Healthcare. “It’s really just in response to the double-digit medical inflation that occurs and continues to occur.”

Several provisions of the health care law take effect for plans renewed after Sept. 23, six months after the legislation was passed.

For many people insured through their employers, these changes will begin in next year’s coverage, which workers are now selecting during an open enrollment period.

Under the law, all plans must cover dependents up to age 26. Children up to 19 can’t be denied coverage due to a pre-existing condition.

Insurers also can’t establish limits on how much they will pay for covered benefits during the entire time an individual is enrolled in a plan. Plans can no longer terminate coverage retroactively due to honest mistakes on applications.

Other rules are contingent on how much employers change their health plans. Among them is a requirement for plans to cover certain preventive services, such as flu shots and some cancer screenings, without charging copays or co-insurance.

Companies can avoid that and some other mandates by basically freezing their plans as of March. To receive “grandfathered” status, a plan cannot significantly raise employees’ responsibility for health costs or substantially reduce benefits. Insurers found that few companies chose this option, though.

Dennis Wance was considering it for his Norfolk-based law firm, Vandeventer Black.

Because of some serious illnesses, health insurance costs would spike next year if his firm chose to grandfather its current plan, he said. However, a new plan probably would mean employees pay a larger portion of their medical bills and receive slightly reduced benefits, he said.

The choice promised to be difficult for a company that prides itself on generous health coverage for its 170 employees.

“These benefits are important,” said Wance, the firm’s executive director. “That’s why we’re reluctant to do some of the more draconian things with medical premiums to get the cost down.”

In some cases, the new law caused barely a ripple in a company’s coverage, especially if its plan already came close to meeting the provisions or if few people qualified for the new coverage.

At T. Parker Host, for example, none of the 56 employees added a new adult dependent, Jenkins said.

Other employers still wrestled with steep increases.

At Hampton-based Old Point National Bank, monthly health premiums rose more than in recent years – between 10 and 20 percent, said Joseph Witt, executive vice president and human resources director.

For his company and its 340 employees, high-deductible plans with health savings accounts have proved a good way to manage costs, he said. Those plans have lower premiums and higher deductibles than traditional plans, and allow employees to save money for medical costs in a tax-advantaged account.

“We’re hoping to one day have all of our employees say, ‘Wow, these high-deductible plans are so great, there’s no reason to be in a traditional plan anymore,’ ” Witt said. “Because the traditional plans are real dogs.”

Insurers said high-deductible plans gained popularity for 2011 because the plans allow employers to pay lower premiums and possibly invest in other benefits, such as matching funds for employee health savings accounts.

Employers also showed more interest in steering employees to wellness programs as a long-term strategy to reduce costs. Programs with incentives, such as gift cards and deposits into the health accounts, tend to work best, said Jeff Ricketts, regional vice president of sales for Anthem Blue Cross and Blue Shield in Virginia. “Cash is king, we’ve found,” he said.

Looking ahead, employers are nervous about future demands of the health care overhaul – even as they wait to see whether it will withstand political assaults.

“I can’t say that the health care reform act has presented, in and of itself for 2011, that significant a challenge for us,” Wance said. “I think those challenges are yet to come.”