September Newsletter: Car Gap Insurance / Healthcare Limits

September Newsletter: Car Gap Insurance / Healthcare Limits


The moment you drive a vehicle off the dealer lot, your vehicle depreciates.
If your vehicle is totaled in a covered loss, you may have to pay out the difference between what you owe and what your vehicle is worth at that time.

Gap insurance covers the difference between what you owe on your vehicle (financed) and what your auto insurance carrier is willing to pay for it (actual cash value).

Car gap insurance (or loan/lease insurance) is sometimes not purchased by our insureds because of the added premium cost or because they assume their Comprehensive or Collision coverage will fully insure their vehicle if it is stolen or totaled. However, you should consider purchasing this coverage as it can be a very costly expense after an auto accident is occurred.

Gap insurance coverage is available for both purchased or leased vehicles.

Call us if we can be of assistance.COLLISION



All health plans that are not grandfathered, whether insured or self-funded are subject to limits on annual out-of-pocket maximums. All cost sharing, such as co-pays, deductibles, and co-insurance, for Essential Health Benefits (EHBs) must accumulate to the plan’s out-of-pocket maximums up to the following limits:

Plan Year Beginning in: Self-Only Coverage Coverage other than self-only
2014 $6,350 $12,700
2015 $6,600 $13,200
2016 $6,850 $6,850 per person
$13,700 per family

Each state, through its state insurance laws, may establish a detailed definition of EHBs for purposes of group health insurance policies issued in that state. Self-funded plans may define EHBs based on general federal guidelines or a state benchmark plan. Generally, an EHB definition includes health care services in the following 10 benefit categories:

Ambulatory patient services
Emergency Services
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Prescription drugs
Rehabilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care (services for individuals under 19 years of age).

The Affordable Care Act (ACA) requires non-grandfathered group health insurance policies sold in the “small group” market to adopt several reforms. For example – coverage of all 10 categories of EHBs. “Large group” policies, currently sold only to employers with at least 50 employees, and self-funded health plans are exempt from the market reforms. Starting in 2016, the definition of “small group” will expand to include groups with 51 – 99 employees.

SEPTEMBER – Prevention Month


This month, stay up-to-date with your immunizations and other preventive care. You can also help keep your immune system strong by eating right, staying active and getting enough rest.

Get a flu shot. Protect yourself, your family and friends by getting a flu shot. Stay at home if you do get sick…don’t spread the germs.

Exercise. Regular exercise (150 minutes a week) can help lower your risk of developing Alzheimer’s disease, diabetes, and stroke. Now that it is getting cooler walk your neighborhood.

Garlic. Garlic contains more than 100 sulfuric compounds that work to fight bacteria and infection. For an extra immunity boost, add garlic to your juice; pasta and pasta sauce; sautéed meats and vegetables. If you do not like the taste or smell of garlic take a garlic supplement.


*Intended for informational purposes only and should not be construed as legal advice.

Protect your Organization from Cyber Risks!

Baker, Romero and Associate’s President, Lillian Romero Gomez, and Michael Hellbusch, esq. from Tredway, Lumsdaine and Doyle presented a seminar on cyber risk and its legal issues at the 9th Annual Gianneschi Summer School for Non-Profits, California State University, Fullerton. A special thank you to Susan Cadwallader, Ph.D, Director of the Gianneschi Center for Non-Profit Research.



Workers’ Compensation Risk- Employees who drive their own vehicles for business use

Employees who use their own vehicles for business purposes represent a significant workerscompensation exposure.

Steps should be taken to assess this workerscompensation exposure as there are serious outcomes after a vehicle crash involving an employee. They include, but are not limited to, the following:

  • Potential costly automobile claim on the organization’s commercial policy (non owned automobile liability). This is especially true if the employee is under-insured or non-insured.
  • Injuries to clients.
  • Potential for increased workerscompensation and commercial insurance premiums.
  • Potential LiabilityEmployer may be responsible for the actions done by their employees.
  • Negative publicity.

It is important to understand your organization’s exposures to losses resulting from crashes when employees travel to meetings and appointments with their personally owned vehicles. It can be challenging to assess your travel exposure, but there are a few methods your HR I Management Department can use to assess your risk:

  • Review mileage reimbursement payments to employees.
  • Review expense reports that show reimbursements for training seminars, industry conferences and off-site meetings.
  • Survey department managers.

Suggestions to help reduce your WorkersCompensation Automobile Risk:

  • When possible, reduce the need to travel by using web-based technology for meetings that involve employees from multiple locations.
  • Host training courses in-house or find web-based courses.
  • Encourage employees to consolidate appointments and plan their routes to minimize distances traveled, exposures on the route and the total number of trips.
  • Require managers to approve all trips.
  • Always obtain Motor Vehicle Reports (MVRs) at hire and annually for all employees who drive company vehicles or regularly drive their own vehicles.
  • Obtain a copy of the automobile insurance declaration page from each approved personal vehicle driver.
  • Establish selection criteria to use when evaluating an employee’s driving record to determine if they are acceptable to drive on company business.
  • Keep updated (annual) copies of licenses on file.
  • Create a mandatory seatbelt policy (even if state law requires them).
  • Develop a Vehicle Use Agreement which clearly spells out company expectations for drivers operating a company vehicle or personal vehicle for business i.e. transporting others.
  • Prohibit nonurgent travel during severe or inclement weather.
  • Limit the number of employees that travel in the same vehicle.
  • Develop a policy on hours of use. Employees should not operate motor vehicles during hours they would normally be sleeping, such as leaving early in the morning to avoid overnight travel expenses.

This is intended to serve as general loss control information provided by loss control resources from Liberty Mutual.  It is not to be construed as legal advice.