Tonik

somarco

GA Medicare Expert
5000 Post Club
36,476
Atlanta
Blue has introduced their new Tonik plan in GA. Like the Right Plan before, this is a CA import where they claim it is selling like hotcakes.

I did attend the initial training class yesterday and here are my observations. Would be interested in feedback from others who have had access to the product in other states.

No waivers (exclusion riders).

"Immediate" underwriting & acceptance for 70% of applicants. (This is the claim by Blue).

Credit for prior coverage against the pre-ex waiting period.

Dental & vision included, albeit limited benefits.

No coinsurance. 100% above the deductible.

Easy to understand coverage.

No maternity benefits.

Underwriting guide is not available to agents. All online info, no "hard" copy. Everything is geared to keep the agent uninvolved in the process.

Online application seems to be easy and a final rate is tendered at the end before you make application (in most cases). Some questions will result in a "referred to underwriting for review" notice.

I see pluses & minuses with this plan. It appears to be overly competitive for the rich benefits offered, but that has never stopped BX before from putting a plan on the streets and then progressively raising rates for future new business & renewal.

When Right Plan was imported 2 - 3 years ago I wrote a fair amount of the product. Now I don't have a single policyholder on the plan as it became too pricey for renewals and totally uncompetitive for new business.
 
Yeah, I forgot to mention that . . .

I don't care for the plan but at the same time I am not going to turn my back on it if someone is interested.
 
I was in the same room as you, Somarco, and was not impressed with the product at all.

I'd rather sell the Blue Value 3000, with Maternity. If they think no single 19 to 29 yr old female is not going to get pregnant, they are mistaken. Lot's of loud music, flashy graphics (which didn't work during our meeting), but not much substance.

And that grid! Oy! What a headache I got looking at it again!

Thanks for the cookie, soda and 2 CE hours, but I'll stick with the Blue Value 3000 for now. That's the only plan I sell of theirs.
 
The cookies were good. Easy way to get 2 hours CE.

Single female wanting maternity can go to KP (no wait) or Time (270 day wait). BV 3000 requires family coverage + 12 month wait.
 
Tonik Health Plans in Georgia

Hello Guys! I am back :). I offer the Tonik in all 4 states and Sound in 2. 
I guess in most of the states there is no brand name coverage period! In some state they give you high deductible for brand name but people will use it when they got seriously ill. 

The Tonik was Big sale in California. I sold about 70 % of my business the Tonik . 
It's great product but in some states they have almost as good and the rate is not higher with full drugs coverage. Big advantage of Tonik or Sound plans the ER flat Fee , 100% after Deductible coverage with out co insurance and in some cases the office visit would include the blood work and x ray if that down inside of office during regular visit. 
here is my website www.tonikppo.com
 

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From "Priced Out - Healthcare in CA"

http://www.insurance.ca.gov/0400-ne...load/Priced-Out-Health-Care-in-California.pdf

or http://tinyurl.com/y77u65

This is terrific study about the entire 'problem' of the industry from a CA perspective.... writen by the CA DOI. The TONIK plan draws special fire from the DOI, page 27:

===========

Specialized products can lead to risk selection and subsequent underfunding of higher risks, especially
when the product is exclusively aimed at saving money. The poster child for these problems is a new
Blue Cross product marketed as TONIK to 18 to 24 year-olds, known as the “young invincibles.” Different
tiers of TONIK, such as “part time daredevil” and “thrill seeker”, enable Blue Cross to offer various
pricing options under this policy umbrella. The most controversial aspect of the product is its exclusion
of maternity care. The cost of a routine healthy
delivery (vaginal birth, no complications, 2-day
hospital stay) in California ranges from $6,500 to
$9,500 and the cost escalates dramatically with a
Caesarean birth or other complications. It is
predictable that many in the young invincible
category will require coverage at some point,
causing them to migrate at least temporarily into
more comprehensive policies or into Medi-Cal
and AIM (Access for Infants and Mothers).

Savings resulting from cutting coverage have
been minimal at best - estimated to range from
zero on the low end to 6.5% on the high end over a
three-year period. They are static savings. Once
the cuts are made, no additional cost savings
accrue from year to year. To generate further
savings requires further limitations on benefits.
To the extent that limitations in benefits or
increased cost-sharing results in patients forgoing
necessary treatment, leaner coverage limits may
end up increasing costs in the long run or trans-
ferring costs to the public sector.

============

The is a long report but if you consider yourself an 'expert' on the industry you should read the entire 70 pages (lots of charts and graphs you can skim over.) Bottom line? The whole system is broken... like you didn't know that? My bet? All of us who sell health insurance in CA will be out of job in 24 months, maybe 36... but it IS going to happen... some kind of state created one-payor system.

Al
 
All of us who sell health insurance in CA will be out of job in 24 months, maybe 36... but it IS going to happen... some kind of state created one-payor system.

That is an interesting observation, and one that I can neither attack or defend since I am unfamiliar with the CA market.

I can say that over the 33 years I have been in this industry there are always SOME groups that forecast the end of health insurance and the government taking over in some form or fashion.

This flies in the face of reality, not the least of which is summarized on page 24 of the report you cite. In essence, the Medicaid system in CA is woefully underfunded and failing rapidly. The same can be said for Medicare on a national basis. Other states have attempted to shore up their Medicaid system without success. One of the more recent failures was Tenn-Care which is on life support if not already given last rites.

The government has proved inept at managing just about everything in public assistance and health care is certainly no shining example. The consumer groups that cry for a govt takeover are grossly misinformed and have no clue how much worse it will be if they do take over the funding & delivery of health care.

There are two industries that are firmly entrenched and will never go away entirely. One is funding for health care, the other is the tax related industry. We will always have private industry involved in funding health care and always have the IRS and all the supporting private entities.
 
al3 said:
From "Priced Out - Healthcare in CA"

http://www.insurance.ca.gov/0400-ne...load/Priced-Out-Health-Care-in-California.pdf

or http://tinyurl.com/y77u65

This is terrific study about the entire 'problem' of the industry from a CA perspective.... writen by the CA DOI. The TONIK plan draws special fire from the DOI, page 27:

===========

Specialized products can lead to risk selection and subsequent underfunding of higher risks, especially
when the product is exclusively aimed at saving money. The poster child for these problems is a new
Blue Cross product marketed as TONIK to 18 to 24 year-olds, known as the “young invincibles.” Different
tiers of TONIK, such as “part time daredevil” and “thrill seeker”, enable Blue Cross to offer various
pricing options under this policy umbrella. The most controversial aspect of the product is its exclusion
of maternity care. The cost of a routine healthy
delivery (vaginal birth, no complications, 2-day
hospital stay) in California ranges from $6,500 to
$9,500 and the cost escalates dramatically with a
Caesarean birth or other complications. It is
predictable that many in the young invincible
category will require coverage at some point,
causing them to migrate at least temporarily into
more comprehensive policies or into Medi-Cal
and AIM (Access for Infants and Mothers).

Savings resulting from cutting coverage have
been minimal at best - estimated to range from
zero on the low end to 6.5% on the high end over a
three-year period. They are static savings. Once
the cuts are made, no additional cost savings
accrue from year to year. To generate further
savings requires further limitations on benefits.
To the extent that limitations in benefits or
increased cost-sharing results in patients forgoing
necessary treatment, leaner coverage limits may
end up increasing costs in the long run or trans-
ferring costs to the public sector.

============

The is a long report but if you consider yourself an 'expert' on the industry you should read the entire 70 pages (lots of charts and graphs you can skim over.) Bottom line? The whole system is broken... like you didn't know that? My bet? All of us who sell health insurance in CA will be out of job in 24 months, maybe 36... but it IS going to happen... some kind of state created one-payor system.

Al

I went to the Warner Pacific Festval and they were talking about this problem. There was research and they prove that if they create that type of system with one systme who will manage all health care it will create even more losses and will cost more money for the state.
 
Bob_The_Insurance_Guy said:
If they think no single 19 to 29 yr old female is not going to get pregnant, they are mistaken.

A major pitfall of many individual medical products out on the market, for what it's worth. I never knew how much maternity expenses could be until I saw the bills and would never sell a limited plan like that to a young female.
 
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