Will Exchanges Replace the Standard Practice Today to Contact Insurance Companies Directly?
- Thread starter glazarev
- Start date
no problem however as you know, it could/can/will/might be changed at the stroke of a pen
Even if given the option, no insurer would allow any time enrollment; that would be financial suicide. Regarding on and off exchange products, remember that major medical isn't the only product and I can see in many instances it isn't the right product...at least not at the prices we are seeing. I agree that if it is on the exchange, it has to be offered off the exchange and same commission on both sides of the wall for the same plans. Just like today, however, the non-major medical plans can and likely will bring higher commissions than major medical which will make them more attractive to the agent and the financial benefits more attractive to the consumer. There will be more options off exchange of which I predict will be better coverage and if you don't at least present these to your clients that are above 300% as an option, I think you are leaving out important information for your consumer. Just be sure to be very clear on the pros and cons for each and every option you present. Fact finding will be even more critical after October 1st.
You think we will need to do the fact finding? Won't the government continue to give us all the facts?
[extreme sarcasm]
The "off exchange" market (which I prefer to call the Private Market) will most likely be substantially larger than the "on exchange" market (which I prefer to call the Govt Exchange Marketplace).
Correct. If the policy is SIMILAR on the Govt Exchange Marketplace as it is in the Private Market plan, then the rates and commissions must be the same. But HHS has a ruling issued about what "similar" means, and one of the things that makes them not similar is a different network.
And, carriers not participating on the Govt Exchange Marketplace can still participate in the Private Market.
Note - the above paragraph is not true in all states. Some of the states that have their own exchanges are requiring carriers who participate in the exchange/marketplace to have identical products inside and out, with identical rates and commissions.
ann... I don't like disagreeing with you... EVER... however some things to think about.
According to reports out 50% of the indy buying public will get subsidies and as we have discussed b4 anyone "close" to the subsidy line, meaning in my view 450% and under probably needs to be steered toward the public FFE. Therefore I see the private exchange gathering about 40% of the indy market share... I made up the 40% cause I felt like in a debate I could justify it.
Just because there are more options in the private exchange dosent mean there will be more market share.... as we have all learned in our years of experience people follow the money and if you be getting a subsidy your toecus will be in the FFE. After a year of two people will get used to the goofy doctor networks.
Here in the great state Baylor hospital was not in any MAPD plans until the 2013 selling season and MAPD plans still were sold like hotcakes. Baylor is a major, big time player. This year a major named provider picked up the network and after reviewing the enrollments they still are nowhere close to the enrollment of AARP... nowhere close...... again, people follow the money and will just switch doctors.
According to reports out 50% of the indy buying public will get subsidies and as we have discussed b4 anyone "close" to the subsidy line, meaning in my view 450% and under probably needs to be steered toward the public FFE. Therefore I see the private exchange gathering about 40% of the indy market share... I made up the 40% cause I felt like in a debate I could justify it.
Just because there are more options in the private exchange dosent mean there will be more market share.... as we have all learned in our years of experience people follow the money and if you be getting a subsidy your toecus will be in the FFE. After a year of two people will get used to the goofy doctor networks.
Here in the great state Baylor hospital was not in any MAPD plans until the 2013 selling season and MAPD plans still were sold like hotcakes. Baylor is a major, big time player. This year a major named provider picked up the network and after reviewing the enrollments they still are nowhere close to the enrollment of AARP... nowhere close...... again, people follow the money and will just switch doctors.
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I still don't see many families over 400% poverty level shelling out 25K per year for these family plans. They better make about $200K, then maybe 25K per year on insurance costs is "affordable"..I just don't know how vibrant the off exchange markets gonna be unless we are selling a boatload of mini meds, again Tater sorry I know you hate that term !
I like your input, Tater.
I think you were referencing my statement, "The "off exchange" market (which I prefer to call the Private Market) will most likely be substantially larger than the "on exchange" market (which I prefer to call the Govt Exchange Marketplace)."
Let me rephrase. I was thinking of the large scope of the market, including large group, self-funded, small group, and IFP. That was my natural thinking as a Group & IFP agent. But I need to remember that most posters on this board are really focusing on IFP when they read this health care reform forum. IFP was really the market that these prior posts were about. So, I agree with you when it comes to IFP, and I agree that money speaks and those subsidies can be very rich.
And, by the way, I don't like disagreeing with you... EVER... either! You are so knowledgeable. You are extremely alert to understanding human nature, what makes people tick, what people will buy (and why), etc. Your post above was an example of your insights. Thanks for sharing.
I think you were referencing my statement, "The "off exchange" market (which I prefer to call the Private Market) will most likely be substantially larger than the "on exchange" market (which I prefer to call the Govt Exchange Marketplace)."
Let me rephrase. I was thinking of the large scope of the market, including large group, self-funded, small group, and IFP. That was my natural thinking as a Group & IFP agent. But I need to remember that most posters on this board are really focusing on IFP when they read this health care reform forum. IFP was really the market that these prior posts were about. So, I agree with you when it comes to IFP, and I agree that money speaks and those subsidies can be very rich.
And, by the way, I don't like disagreeing with you... EVER... either! You are so knowledgeable. You are extremely alert to understanding human nature, what makes people tick, what people will buy (and why), etc. Your post above was an example of your insights. Thanks for sharing.
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I really can't disagree with you on any of this until I see the plans. I suspect off exchange will be very attractive even for some 350+. I completely understand and respect why you feel the way you do about the 450 level and have to say that your reasoning is sound, but for the 350-450, I will take the time to educate both sides of the fence.
Like I said, until we see plans and rates, we don't know if off the exchange will offer similar premiums with lower deductibles etc. As I know you are well aware, 60% actuarial value can be calculated in many ways; some will be very unattractive.
I know historically I have gone on rants in my frustration through all of this but at this point, I will reserve judgement until it's in writing. I say that knowing how frequently you have been right in your predictions, so I am not writing your position off, either.
He does tend to be correct in his predictions, prophesies, and crystal ball projections, doesn't he? It's unnerving. Sometimes I wish I had a finger on the pulse of public opinion like that.
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