Switching agencies can be a profitable move. The undeniable truth in the industry is that no single agency has a monopoly on the best benefits and best pay at every hospital that accepts travelers. No single agency has a monopoly on the "best" recruiters.
So if you keep your eyes open and you give yourself enough time to bid your assignment in the Travel Nurse Auction then you might find an opportunity to switch agencies for better housing, pay, benefits, or personal attention.
But keep in mind that switching employers comes with some hassle and some risk. A little preparation will help you make the change quickly, and smoothly.
Here are four main areas to consider (in order of importance):
Keeping covered by health insurance is absolutely critical. You don't want to embark on a cross country trip in your car without health insurance coverage. For that matter, you shouldn't do anything without adequate health insurance coverage.
The first thing is to know when you can expect health insurance coverage to start with your next agency. Will it be the first day of work, the first day of the first full month, or will you have to wait several months to become eligible?
A great way to find this out is by visiting the Travel Nurse Agency Comparison page or by clicking on any recruiter's link in the Travel Nurse Depot Auction pages.
The next thing you need to know is the type of health insurance coverage your new agency will provide. It's not enough to know that you have health insurance, you also need to know what it covers, what it doesn't cover, and how much you should be expected to pay if you need to use it.
You also should want to find out how much your coverage is going to cost. Some coverage options will be provided free of charge by your agency. Free coverage may be a mixed blessing, depending on what you're looking for.
As with most things in life, you get what you pay for.
HMO
This plan is usually less expensive for a company and it’s employees.
The drawback is that you have to see a “gatekeeper” or general practitioner
before you can get a referral to a specialist. HMO’s are coming under
fire from consumer groups for putting budgets ahead of health considerations.
If you need family coverage, an HMO will almost assuredly be cheaper than a PPO.
PPO
This plan lets you choose from a variety of providers inside of a network. If
you go outside of the network than you pay a higher percentage of the bill.
Depending on the plan, there might be deductibles that have to be met before
the insurer pays for part of your medical expenses.
A PPO plan might be reasonably affordable for you, as an individual. But if you’re looking to cover your spouse and children then it will likely be very expensive.
The ability to go directly to a specialist is a major advantage of this type of plan.
Major Medical
This is the type of plan that you can expect to receive if your recruiter tells
you that the health insurance is free. The plan doesn’t offer nearly as
much coverage as either a PPO or an HMO. It covers you in the event of a major
medical event.
A Few Words About Keeping Medical Costs Down
You’re probably aware that medical costs are going through the roof. Although there are many causes, I want to focus on one that is particularly relevant for travelers.
As a healthcare professional, you’ll be tempted to just go down to the emergency room if you’re feeling sick and you someone to see you right away. Unfortunately, the medical costs for emergency room visits are much higher than regular office visits.
So if you need to go the emergency room then don’t hesitate. But if it’s not an emergency, try to make an office visit. You’ll lower your own medical bills and you’ll help control the costs of the overall agency health coverage plan. If their costs go up then yours will too.
Other Health Benefits
Most agencies offer vision, dental, and prescription plans. Make sure to ask your recruiter if they offer these benefits.
Update Your Information
Every time you relocate to a new assignment, make sure that you ask your recruiter or the human resources executive to change your address. Otherwise, a simple office visit might be considered out of network (in the case of a PPO). Also make sure that you know where to find the website for the insurance company. You’ll want to be able to look up a local doctor at a moment’s notice.
Footprint
Ask your recruiter to give you specifics on how well the insurance company covers the states you’ll be traveling to. Not all insurance companies have equal hospital coverage.
COBRA
COBRA is short for Consolidated Omnibus Budget Reconciliation Act.
If you are entitled to COBRA benefits, your health plan must give you a notice stating your right to choose to continue benefits provided by the plan. If the agency you are departing had more than twenty full time employees last year then you should be covered under COBRA.
Make no mistake about it... COBRA is expensive. You pay the full monthly premium plus two percent to cover administrative costs. Many nurses are surprised to see how much money their agency was paying for their health insurance on their behalf.
You have a 60 day election period starting the day you quit during which you may choose to accept coverage. If you let the sixty day election period pass, you lose all rights to benefits.
You must make your first payment within 45 days of your election of COBRA benefits. That first payment must cover all of your health insurance premiums from the first day you were eligible for benefits ( the day you left your agency).
Coverage usually lasts 18 months (longer in special cases). You're not required to pay for the full 18 months. You can quit paying at any time. Just don't be thirty days late on a payment or your coverage could end before you wanted it to.
Savvy travel nurses will consider getting their own private insurance policies. A private policy will stay with you whenever you change jobs so COBRA hassles or health insurance gaps shouldn't be an issue. Depending on which type of policy you choose, you will probably find that the quality of the insurance is much better than the typical "free" policies offered by some agencies.
Travel nurses that are relatively young and in good health should strongly consider purchasing a private policy. Health insurance companies reserve the young and healthy. There's no money in insuring sick people.
Snide remarks about ruthless insurance companies aside, you should be aware that private plans can be difficult to find, purchase, and afford if you have pre-existing conditions. Any private policy will most likely stipulate that the pre-existing condition isn't covered.
If you decide to purchasea your own health insurance policy, here are some places to start your research:
ehealthinsurance.com
Fortis
Humana
Golden Rule
Aetna
Your investment is portable—you can take the money with you. When you switch employers, you have several options regarding your 401(k) plan money, each with its own tax implications.
Not all agencies offer life insurance or disability insurance so make sure to ask. Typically the coverage amounts for your life insurance will be low but you can often “buy them up”… meaning that you can pay more to have higher coverage.
Disability Details
Disability insurance is quite a bit more confusing than life insurance. Here
are some important terms to understand:
Definition of Disability
It’s important to know what has to happen to you in order for you to be
considered disabled. Your insurance company will use one of these definitions:
Own Occupation – Under this definition, you are considered disabled if you are unable to perform the basic functions of your current occupation.
Any Occupation – Under this definition, you are considered disabled only if you are unable to perform the basic functions of any occupation.
Waiting Period
This determines the number of days that you have to be considered disabled to
start receiving benefits. Ninety days is common.
Tax Consequences
Disability benefits will be considered taxable income if your premiums are deducted from your paycheck before taxes. If you pay for your premiums with after tax dollars then your disability benefits should be tax free.
Life insurance proceeds are tax free to your beneficiaries.
Consult a tax professional for specific advice and for further clarification.
As you may already know, there is a mountain of paperwork that comes with being a travel nurse. First, there's the regular profile:
Eventually you'll also need to fill out an application for the agency you want to work for and you'll need to supply some, if not all, of these other documents:
Travel Nurse Depot is quickly working on several solutions to the paperwork hassles that travel nurses face. In a matter of days or a few short weeks, we'll be announcing these new programs.
Stay tuned....