Blown Away

[somarco]

I have a small group client (5 lives) that I have been trying to move away from copays to an HSA. His renewal is coming up (18%) and he is finally asking me about the HSA.

Humana's renewal generates a monthl premium of $2417. Changing to the group HSA drops the premium to $1937.

Individual HSA's with Humana are $1428.

The big surprise came with Aetna's new rate structure. Monthly premium is $1039.

Final premiums will increase slightly as there are a few health issues but nothing dramatic. And they forfeit maternity but this only affects one employee and they can pick a different plan if they choose.

Pretty amazing.

 

[NewHealthStrategies]

The big surprise came with Aetna's new rate structure. Monthly premium is $1039.

You're saying the Aetna individual rates for the HSA were $1,039? SWEET

I predict we'll see a re-emerging discussion about taking employers OUT of group and into individual.

BTW Bob.... how Assurant HSA business do you do.... I haven't done much till today when looking and they blew the doors off everyone else on a $5,100 deductible plan for a 56 year woman.

Also heard that Assurant LOWERED their rates by like 40% in 30+ States (of course, Georgia was not one of them).

 

[somarco]

Almost no Time biz. Not competitive and underwriting is a pain in the butt.

They have had better rates than competitors on ages over 55. Most of my Time clients are late 50's to early 60's.

They have lowered rates a few times in GA but so far off the mark it doesn't matter. Figure +25% per med.

Last case I wrote and they increased the rate 25% on a $5800 SIR for anti-depressants. First time the guy went for a refill, no discount, no credit towards deductible.

WTF?

Time finally admitted they should not have rated him up since they don't cover psych benefits in GA. They credited the premium overcharge on his next bill.

What are you doing writing a $5100 SIR? Isn't that a Right Start deductible?

If so, that's a piece of crap policy.

 

[NewHealthStrategies]

Almost no Time biz. Not competitive and underwriting is a pain in the butt.

They have had better rates than competitors on ages over 55. Most of my Time clients are late 50's to early 60's.

They have lowered rates a few times in GA but so far off the mark it doesn't matter. Figure +25% per med.

Last case I wrote and they increased the rate 25% on a $5800 SIR for anti-depressants. First time the guy went for a refill, no discount, no credit towards deductible.

WTF?

Time finally admitted they should not have rated him up since they don't cover psych benefits in GA. They credited the premium overcharge on his next bill.

What are you doing writing a $5100 SIR? Isn't that a Right Start deductible?

If so, that's a piece of crap policy.

Once the side-by-side was done, looks like Humana will win this one, but I was thrown by the low-ball premium going in... until you get to the caps on Outpatient, etc.... this was an older woman, almost 60... so that the older age being competitive comment appears to be holding true.

Aetna looked strong on their rates... as well.

 

[somarco]

Two carriers generally look better over age 55 and particularly 60+.

Time and BX.

Aetna and H1 can compete but at older ages look to Time & Blue first. Wonder how much that will change with the new Blue plans that come out in August?

 

[bluemarlin08]

Does it make you nervous about such a big swing in premiums? Are the other companies quotes just off base, and is Aetna low balling to get in? I certainly don't have the answers, but it always confuses me when there is a quote so different than other quality carriers. How do you see it?

 

[Crabcake Johnny]

Aetna low-balled the MD market. The same plan that cost $363 in '05 now cost $696. Almost a 100% increase.

Time in MD seems to be the exactly opposite of GA; decent rates now for under 55 - very uncompetitive over 55.

What's odd to me is GA has less mandates than MD yet GA doesn't seem to allow RX caps? No RX caps on GR or Coventry - in MD caps both on GR and Coventry.

Maybe the MD DOI can take some lessons from GA.

 

[somarco]

This is Aetna's 4th yr in GA and they just recently changed networks. More docs, more counties, bigger discounts.

Their HSA was never in the market and it is an embedded deductible (which I do not like). In thi s case, it is a good fit even with the embedded deductible.

Their copay plans are still middle of the road in Atlanta. Look better in rural areas but I don't like the OOP, especially on higher SIR's.

They also abandoned the 5 yr rate bands which is a positive. Makes them more competitive, especially when paired with a better network.

H1 was never competitive here. Last yr they introduced new plans and a different network. The network makes a major difference in pricing. There are areas's in GA where they use the old network and pricing is mediocre.

The only plan they have that is probably underpriced is Monogram . . . and I sell a lot of Monogram plans. Everything else seems to be in line.

 

[Crabcake Johnny]

DME for Aetna in MD= $2,000 cap. Never a fan of it.

 

[STIBROKER]

DME for Aetna in MD= $2,000 cap. Never a fan of it.

a pacemaker is considered durable medical equipment.....