- 14,809
It's the rates and plans are not competitive - don't offer 'em
World Insurance
- Thread starter sunmed
- Start date
- 14,809
Yes - more difficult to do apples to applies for copay plans. Different ways the drug benefit works, different ways in-office lab is handled.
- 3,345
Agreed. And why does American Republic sell through some reps in areas, while excluding other agents that used to sell American Republic NOW telling them (like me) they must now only sell World health insurance? Confusing? 100% confusing! Please explain this to me: Why did I used to be able to sell American Republic, now they tell me I can only sell World Insurance, but there are still some agents in my area selling American Republic? What and why in the world is this happening? I hate the confusing way American Republic and World market their products. This alone makes them 2nd tier, I don't care what anybody says...There is no uniformity in their marketing channels and product lines, confusing as HELL and 2nd tier B.S...Please somebody explain this to me..I don't care how good their products look on paper, why are they confusing the channels they sell through and what is the relationship with American Republic and World and why can't I sell both?!?
healthagent;125401All carriers pay claims as stated in the policy. I fully agree Bill - I've seen unjustified rate increases with "1st tier" carriers so really - what's the difference. .[/quote said:
Last edited:
AR used to be captive, then they tried brokerage, then back to captive and now a mix.
AR private labels a product thru a handful of IMO's, unlike World who has dozens. With both carriers there are slight differences in the products, not enough to make a big difference.
I can't figure out why carriers do this. It is expensive to develop multiple products and file with each state. They can save some money by offering the plans thru an association and playing off the deemer provisions in most states.
The more variables offered across product lines, and within the same product, the more expensive the product is to administer. One carrier has around 3,000 variations on a dozen or so plans. That is terribly expensive to administer.
Most carriers have figured out it is easier to offer fewer than two dozen variations that cover most benefits people look for. The result is lower admin costs that can be reflected in higher premiums.
As indicated earlier, World was a family owned company, as was AR, until a few years ago. World sold to AR and things (for World at least) started a downhill slide.
They were one of the first health carriers I contracted with and found them to be very responsive. More so than other carriers. An agent could actually talk to a real person, including underwriting, any time.
Not so any more.
AR private labels a product thru a handful of IMO's, unlike World who has dozens. With both carriers there are slight differences in the products, not enough to make a big difference.
I can't figure out why carriers do this. It is expensive to develop multiple products and file with each state. They can save some money by offering the plans thru an association and playing off the deemer provisions in most states.
The more variables offered across product lines, and within the same product, the more expensive the product is to administer. One carrier has around 3,000 variations on a dozen or so plans. That is terribly expensive to administer.
Most carriers have figured out it is easier to offer fewer than two dozen variations that cover most benefits people look for. The result is lower admin costs that can be reflected in higher premiums.
As indicated earlier, World was a family owned company, as was AR, until a few years ago. World sold to AR and things (for World at least) started a downhill slide.
They were one of the first health carriers I contracted with and found them to be very responsive. More so than other carriers. An agent could actually talk to a real person, including underwriting, any time.
Not so any more.
- 3,345
Seriously: Companies like World and American Republic in most areas ARE second tier...Their "massive" but unimpressive product offering may benefit a client for a year or so, but after that watch out - they don't have the market share to spread the risk around, thus rates go up astronomically. Second, if these carriers like AR and World don't "own" a health network in your area and they simply rent a health network in your area, they can't possibly keep their costs down in the long run like the other tier one carriers that contract directly with health providers for a health network. My opinion. Am I right or wrong?
You catch on fast.
Market penetration, low admin costs and managing the product from an underwriting standpoint determine overall competitiveness and longevity.
If you don't write enough business, you have a smaller pool to absorb large claims, even with adequate reinsurance. One reason why carriers don't offer maternity is the potential for a large claim and a relatively small premium base.
I still can't figure out how Celtic survives. They are not even on the radar in most areas.
Humana was all but dead here (and probably other states as well) until they decided to focus on the individual major med market. They have the resources and base to make them a long term player by keying off their group block.
Same for Aetna and Cigna.
While Cigna appears to be trying to find themselves in the individual market, if they get serious about that market they can be a major player.
Aetna has been in the individual market, out, then in again. Supposedly they are committed to that market but time will tell.
Aetna, Cigna, Humana & United have the client base in the group market to do anything they want in the individual market and dominate . . . even in states where Blue seems to own the market. Because of their structure, Blue is really more of a regional carrier and can't really compete (at least not for long) when Aetna, Cigna, Humana & United decide to flex their muscle.
All 4 of those carriers, and Blue makes 5, own their own network. Humana manages Rx internally while United uses a PBM. I don't recall how Aetna handles it and haven't checked out Cigna so I can't say what they do.
It makes no sense for UHC to use a PBM but they do. Their market penetration in the Medicare & group market should make it relatively easy for them to handle meds internally rather than farming out to Medco.
Got a response from Aetna. They use Express Scripts as their PBM.
But back to AR/World.
I don't see them making any major inroads into the individual major med market. They will most likely remain a minor player and may eventually retreat from the major med market like other players of similar size have done.
Market penetration, low admin costs and managing the product from an underwriting standpoint determine overall competitiveness and longevity.
If you don't write enough business, you have a smaller pool to absorb large claims, even with adequate reinsurance. One reason why carriers don't offer maternity is the potential for a large claim and a relatively small premium base.
I still can't figure out how Celtic survives. They are not even on the radar in most areas.
Humana was all but dead here (and probably other states as well) until they decided to focus on the individual major med market. They have the resources and base to make them a long term player by keying off their group block.
Same for Aetna and Cigna.
While Cigna appears to be trying to find themselves in the individual market, if they get serious about that market they can be a major player.
Aetna has been in the individual market, out, then in again. Supposedly they are committed to that market but time will tell.
Aetna, Cigna, Humana & United have the client base in the group market to do anything they want in the individual market and dominate . . . even in states where Blue seems to own the market. Because of their structure, Blue is really more of a regional carrier and can't really compete (at least not for long) when Aetna, Cigna, Humana & United decide to flex their muscle.
All 4 of those carriers, and Blue makes 5, own their own network. Humana manages Rx internally while United uses a PBM. I don't recall how Aetna handles it and haven't checked out Cigna so I can't say what they do.
It makes no sense for UHC to use a PBM but they do. Their market penetration in the Medicare & group market should make it relatively easy for them to handle meds internally rather than farming out to Medco.
Got a response from Aetna. They use Express Scripts as their PBM.
But back to AR/World.
I don't see them making any major inroads into the individual major med market. They will most likely remain a minor player and may eventually retreat from the major med market like other players of similar size have done.
Last edited:
Good point. Assurant is another example of strong agent brand but lesser consumer awareness.
Similar threads
