A.D. 2014: Experts Say, “Plan for the Worst”

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A.D. 2014: Experts Say, "Plan for the Worst"

PPACA Gathering Regulatory Momentum


October 4, 2011 By Allison Bell


hospital_blue-AP-crop-300x200.jpg
A nurse and hospital staff member confer on a hospital skyway in Athens. (AP Photo/Petros Giannakouris)

Prudent insurers, employers and benefits advisors should take the same "better safe than sorry" approach to planning for the Patient Protection and Affordable Care Act that they'd take to planning for computer problems, or a major hurricane.
Panelists agreed on that point Monday during a panel discussion on employer implementation of PPACA organized by Ernst & Young L.L.P., New York.
Edward Pudlowski, a benefits expert at the firm, participated along with Michelle Reinke Neblett, director of labor and workforce policy at the National Restaurant Association (NRA), Washington.
Pudlowski and Neblett touched briefly on the view of some employers that PPACA might "just go away," either because of congressional action or possibly because the Supreme Court will find that the provision requiring many individuals to own coverage or else pay a penalty is unconstitutional.
The NRA is no fan of PPACA, but Neblett shrugged when asked about the idea of PPACA vanishing.
Federal agencies "are certainly implementing this law," Neblett said. "You don't just stop that overnight."
If the 2012 elections break in favor of Republicans and Democrats with concerns about PPACA, that could change the situation, Neblett said.
But, Neblett said, even if the mix in Congress changes, some of the regulations are already written.
"It's very hard to roll those back," Neblett said.
Pudlowski said depending on the idea of a change in Washington leading to the disappearance of PPACA is unwise.
"This snowball is rolling downhill and getting bigger and faster every day," Pudlowski said. "Quite honestly, I think it's hard for it to be repealed."
Insurers, employers and advisors should start to plan for the worst case scenario now rather than count on repeal, Pudlowski said.
The speakers talked about the possibility that an employer that offers solid health benefits could still be penalized as if it offered none if the cost to the employee exceeds 9.5% of a full-time employee's wages from that employer.
Aside from the fact that the provision seems burdensome, applying the provision will be complicated, Pudlowski said.
"One of the big struggles is determining who's a full-time employee," he said.
The task is especially difficult at restaurants and other employers with hourly workers and rapidly changing schedules, Neblett said.
"You may not know who's going to be full-time when they walk in the door," she said.
Another concern is that federal agencies are releasing the regulations and other documents implementing PPACA in dribs and drabs, Neblett said.
"Business owners want to know the full picture," Neblett said.
 
The snowball is coming and you better get out of your igloo fast!!!
Indy health care is dead and buried so move on to life, LTC and disability.

Disclaimer: I have not gotten out yet. As the captain of the sinking ship...I will make sure everyone is safely off the boat. Then...well...I won't tell you what happens next.
 
I strongly disagree with the sense that all is doom for medical, and brokers in general. All is has done is changed the environment and some of us will adapt and survive, some will not.

To begin with, regardless of what occurs legally, the trend for less commissions will continue. For those of you in the business for 20+ years, just look at what the commissions scales were like and what they are now...less.

A successful benefits broker will need to round out their portfolio's to include self-funded, DI, dental, etc. Additionally, they will need to become more efficient in their sales process. And last but not least, many will need to sell differently. Spreadsheets and rates are a thing of the past.

Just my 2 cents.
 
To begin with, regardless of what occurs legally, the trend for less commissions will continue. For those of you in the business for 20+ years, just look at what the commissions scales were like and what they are now...less. Just my 2 cents.

I remember complaining to Conseco when they lowered their commission from 35% to 30%. They responded by going out of business!

Bright Idea?: Why doesn't the U.S. Government just expand upon the Veterans Administration medical clinics and hospitals model by building more facilities, and making them available to people who are poor and those who don't qualify for private insurance? It seems that this would be cheaper than forcing and enforcing the entire private medical and insurance industry to follow 2,000+ pages of rules and regulations!
-Allen
 
Why does anybody even give a rats ass anymore about the PPCCAA or whatever the hell this piece of shiat legislation is?
As it stands, this single piece of legislation its going to ruin our country and career. I'm not being sarcastic, but serious. Really - how many freakin' stars have to align to sink Obamacare? Who is really counting upon either a full or partial repeal, a new President, a new Senate??? Seriously folks, I'm not out of the game but health insurance as we know it - is there even a glimmer of hope left? Serious questions, and no Allen - I'm not knocking you brother - I'm trying to spark a serious discourse because many here seem to think this health bill is a joke and is simply going to be repealed, replaced, modified, etc...BUT again, if all the stars don't align and this thing is crushed, then what? Again, I'm done holding my breath and waiting for this bill to go away. And Leveena - how lean and mean in your sales process and how many ancilliary products do you have to sell to replace an income, and at what cost of marketing just to sell replacement products for major med? I don't know of ONE person in the industry YET who was an indie health jockie replacing the bulk of their income YET with ancilliary replacement products. My opinion, you gotta focus on another major line or two and do an about face. Selling DI, dental, accident, CI,and a little life sprinkled in for good measure, seriously folks who is making over 100K doing this? I doubt anybody here, maybe 1% of us. Furthermore, if you aren't selling a boatload of CI And DI to replace your income, yea good luck with dental then - what are you gonna do even if its repealed or scaled back...? The damn feds and the states are already implementing this piece of garbage health bill and the tentacles of the "exchanges" are being built already, who says all that crap is going away even if this health bill flies away like a bird thru repeal? Again, I'm just saying, its such a mess....Somebody enlighten me why I'm wrong. Some days I would like to see the glass half full. And no, I don't wanna hear, the agent will always have to be involved and paid in selling health insurance. Thats too simplistic of an argument...What I wanna know is seriously whos going to make a living at this anymore selling policies with a $50 app fee. Its a JOKE people. Maybe the worst enemy is the big health companies we sell to under 65ers anyway, they could care less about us, they just want freakin volume business, regardless of how they get it. Hell, they don't care if they have 250,000 community organizers signing up idiots into Obamacare, that would suit the UHCs and Humanas and Anthems just fine don't you think? Tell me tell me health experts I am wrong. I beg you.
 
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HealthGuy, sadly, what you say is true. I am an indy agent, and have been for a long time. The volume of business we have done, and the subsequent renewal commission has allowed me to live a comfortable, middle class life, with some savings put aside (although not nearly enough yet). I have been able to provide for my kids, work from home so I was here when they got home from school. I have been able to help out family members when they fell on hard times, not expecting to be paid back. I have employed people, allowing them to do the same. Unfortunately I have had to lay a couple of them off, which really stinks with Medicare AEP at the front door. But what do you do, you work harder with less. Better off for now than the people out there who have been laid off their jobs completely.

I too had been living in denial, but the sad truth hit me one day when our H1 regional rep had a meeting with us and started showing us these ancilliary products you mentioned, and acted like this was the way to keep us going strong and viable (being they were busy slashing commissions). I remember thinking to myself, this is it, we're toast and they know it, and/or they were thinking they are toast as well, since they seem to be investing a lot into these products, maybe, maybe not. Been searching since before that for another business. Time is running out since I would love to get into something else to see if it works before the renewal income goes away completely. Gotta plan that it will come 2014.
 
Runner: Appreciate the heartfelt and insightful response, this is the type of honesty I'm looking for on the forum...My hats off to you. I don't want to hear it any other way anymore, if I hear one more company rep telling me to go out and sell more CI or Dental I'm gonna....And again, I sell it, its just not realistically replacing a full income, no way. Again, runner good stuff. Anybody else up for posting whats on their mind - commissions can only go so low on major med before its not worth it. And I don't wanna hear diversify and adapt, we are all trying that, I'm just looking for honesty here. What runner says is key: some of the big players are NOW dropping renewals again on an existing block of business we have written..they can do it, and they are!
 
Why does anybody even give a rats ass anymore about the PPCCAA or whatever the hell this piece of shiat legislation is?
As it stands, this single piece of legislation its going to ruin our country and career. I'm not being sarcastic, but serious. Really - how many freakin' stars have to align to sink Obamacare? Who is really counting upon either a full or partial repeal, a new President, a new Senate??? Seriously folks, I'm not out of the game but health insurance as we know it - is there even a glimmer of hope left? Serious questions, and no Allen - I'm not knocking you brother - I'm trying to spark a serious discourse because many here seem to think this health bill is a joke and is simply going to be repealed, replaced, modified, etc...BUT again, if all the stars don't align and this thing is crushed, then what? Again, I'm done holding my breath and waiting for this bill to go away. And Leveena - how lean and mean in your sales process and how many ancilliary products do you have to sell to replace an income, and at what cost of marketing just to sell replacement products for major med? I don't know of ONE person in the industry YET who was an indie health jockie replacing the bulk of their income YET with ancilliary replacement products. My opinion, you gotta focus on another major line or two and do an about face. Selling DI, dental, accident, CI,and a little life sprinkled in for good measure, seriously folks who is making over 100K doing this? I doubt anybody here, maybe 1% of us. Furthermore, if you aren't selling a boatload of CI And DI to replace your income, yea good luck with dental then - what are you gonna do even if its repealed or scaled back...? The damn feds and the states are already implementing this piece of garbage health bill and the tentacles of the "exchanges" are being built already, who says all that crap is going away even if this health bill flies away like a bird thru repeal? Again, I'm just saying, its such a mess....Somebody enlighten me why I'm wrong. Some days I would like to see the glass half full. And no, I don't wanna hear, the agent will always have to be involved and paid in selling health insurance. Thats too simplistic of an argument...What I wanna know is seriously whos going to make a living at this anymore selling policies with a $50 app fee. Its a JOKE people. Maybe the worst enemy is the big health companies we sell to under 65ers anyway, they could care less about us, they just want freakin volume business, regardless of how they get it. Hell, they don't care if they have 250,000 community organizers signing up idiots into Obamacare, that would suit the UHCs and Humanas and Anthems just fine don't you think? Tell me tell me health experts I am wrong. I beg you.



I couldn't have said it better myself......
 
Runner: Appreciate the heartfelt and insightful response, this is the type of honesty I'm looking for on the forum...My hats off to you. I don't want to hear it any other way anymore, if I hear one more company rep telling me to go out and sell more CI or Dental I'm gonna....And again, I sell it, its just not realistically replacing a full income, no way. Again, runner good stuff. Anybody else up for posting whats on their mind - commissions can only go so low on major med before its not worth it. And I don't wanna hear diversify and adapt, we are all trying that, I'm just looking for honesty here. What runner says is key: some of the big players are NOW dropping renewals again on an existing block of business we have written..they can do it, and they are!

Yeah - I'm bummed because even though insurance sales doesn't necessarily get you really wealthy, I have enjoyed a really good quality of life with this business (and my children too). I haven't had to sit in Atlanta traffic since the late 90s, I can work out and stay in shape without sacrificing time with my kids, heck I make them work out with me! It's hard to find another business that has that type of freedom. Still looking and hoping though, the clock is ticking. I can't afford to retire, especially with no residual.

On the bright side, we sold a long term care policy this week, a couple. Yeah! Just need 10 of those a month, yeah sure. Man the paperwork is a bear!
 
H1 regional rep had a meeting with us and started showing us these ancilliary products you mentioned, and acted like this was the way to keep us going strong and viable

You were there too?

They had a meeting at the Marriott Perimeter Center last year and said they would have 40 ancillary products for us within a couple of years.

Not only is that not going to happen but they can't even automate the ones they have. How much time will I spend completing a paper app for a $16 monthly vision plan even if it paid 30% commission?

None at all.

But I will send someone a link and let them figure it out themselves.
 
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