Trying to decide what to propose....

[joshril]

I have a client that is paying $1000/mo for coverage with World... of course it has gone up on them every year or so.. They are on the World HD plan 80 with a $5450 deductible.

I have run some numbers with a few carriers and I am leaning toward Assurant so I can lock in rates for 36 months. After talking with them tonight, that was their biggest concern is locking in rates for the next 3 years as one will be on Medicare in the 3 years the other in 4 years..

I am coming up with $897/mo on Maxplan with $3500 ded and 50% to $2500... (small amount of load added for controlled HBP)

I also have run the one deductible plan in order to give a better "apples to apples" comparison to World. I come up with a little lower premium but I have to go to the $7500 deductible in order to lock in the rate.

They complained about the deductible a bit, so I'm leaning towards pitching Maxplan, but it technically leaves them with a little more exposure than their current plan.

Suggestions??

 

[Bob_The_Insurance_Guy]

If locking in the rate is truly the biggest concern, then you need to inform them that the One Deductible $7,500 plan is your recommendation, and that will get them to Medicare eligibility.

I truly hope you are proposing the 100% plan. This keeps things easier for them. All they have to remember is meeting the $7,500, and that's it.

 

[J.R.]

If locking in the rate is truly the biggest concern, then you need to inform them that the One Deductible $7,500 plan is your recommendation, and that will get them to Medicare eligibility.

I truly hope you are proposing the 100% plan. This keeps things easier for them. All they have to remember is meeting the $7,500, and that's it.

Great idea. I LOVE the 3 year rate guarantee! I'm not up to speed on the World plans yet so refresh my memory. does the world plan come with come with accident protection, and if so how much and who is written by?

I vaguely recall K-Dub telling me that the World plans come with accident protection build in, but I could be wrong depending on the plans.

 

[joshril]

If locking in the rate is truly the biggest concern, then you need to inform them that the One Deductible $7,500 plan is your recommendation, and that will get them to Medicare eligibility.

I truly hope you are proposing the 100% plan. This keeps things easier for them. All they have to remember is meeting the $7,500, and that's it.

Would the MaxPlan with individual deductible of 3500 not make more sense?? They are currently on a World 5000 ded HSA with 80%

 

[bluemarlin08]

How much do they have accumulated in their HSA account. You might look at the 10,000 deductible if they have that much in their account anyway.

 

[Bob_The_Insurance_Guy]

Would the MaxPlan with individual deductible of 3500 not make more sense?? They are currently on a World 5000 ded HSA with 80%

They are already on a HDHP. Why move them off that?

They've already shown you that they are comfortable with a One Deductible situation, and are just looking to lower their monthly premium until they (or one of them, anyway) becomes Medicare eligible. You are doing nothing more that what you would do if they were on a copay plan. You are raising the deductible to make the monthly premiums more affordable. Only, with this situation, you are locking them in for the next 3 years.

"Mr. Smith, this is my recommendation. The reason I am recommending you go with the $7,500 deductible is to do two very important things. For one, by doing so, we are able to guarantee that your monthly premium will not increase for the next 36 months of coverage. You know, for the next 3 years, you can budget XX amount of dollars for healthcare premiums, without the worry of getting an increase notice, when you least expect it. Secondly, we are lowering your monthly premium. As you know, the higher the deductible, the lower your monthly premium. We are keeping you in the same plan design you have been comfortable with, lowering your monthly premium by XXX$ per month, and only increasing your out-of-pocket maximum less than $7 a day. Seems fair, doesn't it?"

 

[somarco]

How much do they have accumulated in their HSA account

Based on what most folks do, probably less than $1000.

I agree with Bob #2 . . . keep them in the HSA. Their liability with the World plan is $10,000 per couple since it has the 80% coinsurance. Only plus is a lower entry point ($5,000 vs $7500).

Add on the Secure Solutions rider and you can have a plan with even less out of pocket for accident or critical illness. Overall, a better plan than they have now.

The HDHP plan with World may not include Rx. Check their policy to see. Some of the agents sell the cheapest thing they can and leave off the Rx benefit and sell the 80% option to keep the premium down.

If you are trying to sell rate you will lose. You must sell benefit & value . . . which is what you should always sell.

 

[K-Dub]

I vaguely recall K-Dub telling me that the World plans come with accident protection build in, but I could be wrong depending on the plans.

World does not have an accident plan built into their plans. It would be a third party plan that would protect them on the accident side. Just FYI!

 

[J.R.]

World does not have an accident plan built into their plans. It would be a third party plan that would protect them on the accident side. Just FYI!

Gotcha, thanks for the clarification.

 

[joshril]

They are already on a HDHP. Why move them off that?

They've already shown you that they are comfortable with a One Deductible situation, and are just looking to lower their monthly premium until they (or one of them, anyway) becomes Medicare eligible. You are doing nothing more that what you would do if they were on a copay plan. You are raising the deductible to make the monthly premiums more affordable. Only, with this situation, you are locking them in for the next 3 years.

"Mr. Smith, this is my recommendation. The reason I am recommending you go with the $7,500 deductible is to do two very important things. For one, by doing so, we are able to guarantee that your monthly premium will not increase for the next 36 months of coverage. You know, for the next 3 years, you can budget XX amount of dollars for healthcare premiums, without the worry of getting an increase notice, when you least expect it. Secondly, we are lowering your monthly premium. As you know, the higher the deductible, the lower your monthly premium. We are keeping you in the same plan design you have been comfortable with, lowering your monthly premium by XXX$ per month, and only increasing your out-of-pocket maximum less than $7 a day. Seems fair, doesn't it?"

My dilema is they have expressed some discomfort with their current deductible, but also need something to lock rates in... That is my reasoning for looking at the MaxPlan with individual deductibles that are lower... If Assurant offered a 3 year lock on a $5000 one deductible plan I would do that... And also, lowering premium isnt' as important as assuring it won't increase further.