New (ish) Individual Health Plans in Maryland

[Sam]

Carefirst has recently rolled out some HSA plans on the individual side that are a pretty good buy. Previously, the biggest problem with their plans was the 500-1500 cap on prescriptions, which you can blow through in a minute with some drugs.

They have an HMO HSA and a PPO HSA that do not have any caps. Once you hit your deductible, the plan is a 5/25/45 plan.

The other issue that some people have with these plans is that they don't illustrate the outpatient therapy benefits. I was told that they are working on putting them on the new plan specs, but that they are there with a $30 copay.

On these plans, preventive care is free, and there is a low deductible option of $1,200/$2,400 A fairly healthy 45 year old would pay $331/month for FAMILY coverage with a $2,400 deductible on the HMO. This is with 100% co-insurance and a $4,800 out of pocket max. The one drawback is the $600/day inpatient hospitalization copay, but with a low out or pocket max, it is somewhat mitigated.

To the best of my knowledge, there is no other HSA in Maryland that can be used with an HMO, and their steep network discounts are what makes this possible.

From an agents perspective, their commission stinks, at $23-$25 a head, but for a case that will stay on the books, it isn't a bad deal (no dip after 1st year), and for younger people or singles, it is a steal.

 

[Crabcake Johnny]

To say that it's cheap is the understatement of the century!!!

https://www.carefirst.com/eSales/br...70611&packageId=37&planIdx=1&ts=1168958186934

How 'bout a family where the oldest is 40 at $210 a month!!! And remember there's no rate-ups for smokers with Carefirst - so that could be a family of 5, both 40 year old smokers and the rate is still $210??? !!!

Wow - this will definitely be pitched by me starting today! My problem with Carefirst in the past has been that drug cap, but this is simply phemonimal.

 

[Sam]

I thought you would like that! Just as a side note, the PPO is also very reasonably priced, but maternity is an extra $126/month. On the HMO, it is included at no extra charge.

 

[Crabcake Johnny]

Also remember that while the OOP is $5,250 any individual only has to meet $2,600 - much different from the other HSAs I sell where any individual has to meet the full $5,600.

This is nuts. This will get me three extra deals per week guaranteed - especially from older smokers who I typically lose over price.

 

[STIBROKER]

Wow - this will definitely be pitched by me starting today!

WITH A WARNING.....

 

[Crabcake Johnny]

Which would be what?

 

[STIBROKER]

as in mean rate increase in the next year or two......only time will tell.....

 

[Crabcake Johnny]

Male 45, female 45 both smokers with 2 kids:

Blue Choice: $264 per month
Assurant HSA: $582
Aetna HSA: $537
Golden Rule HSA: $465

That's almost half the price of the next cheapest plan so would difference would the rate increase make? Even if they whacked them with 25% then $264 turns into $330. Remember also that all those other carriers are also gonna hit people with around 20%. Also remember the Carefirst is domiciled in MD and is not association coverage which means all rate increases must be approved by the MIA.

 

[STIBROKER]

and if it looks to good to be true.........

 

[Crabcake Johnny]

Agreed. The prices are so low I'm wondering how Carefirst plans on pulling this off.

The ethical question is do I have my clients be the guinea pigs? Is this going to be so heavily managed that claims/procedures/testing/treatment will be declined/postponed?

However, this is neither here nor there when I have a family of 5, husband and wife smoke and they're in their 50's and can't afford anything else. In the past it was simply a dead deal. Now it's not.

But you could apply the "if it's too good to be true" mentality to Unicare in TX. Their rates are much lower than Assurant and Aetna. A savvy client could compare Unicare to Assurant and Aetna and say "Scott, these Unicare rates are much cheaper then the competitors. I guess there must be a catch somewhere. What it is?"