Any where to learn Group Health Insurance 101?
- Thread starter Phil C.
- Start date
- Thread starter
- #22
G
Guest
Guest
A good book for employee benefits is
Employee Benefits by Burton T. Beam jr and John Mcfadden
Its a little pricy but you can often find it on half.com for a decent price.
Employee Benefits by Burton T. Beam jr and John Mcfadden
Its a little pricy but you can often find it on half.com for a decent price.
- 176
Depending on what part of Illinois - I have a couple of GA's I've worked with. PM me if you'd like their contact info.
SC Local LAH Agent
Expert
- 61
I am looking for a GA here in SC to help me add group plans to what I offer. Seems benefit-mall doesn't not do group here in SC. Also having a hard time getting the local Rogers Benefits office to call me back. Any ideas?
Executive Benefits
Expert
Try Excelsior
- 596
I also think it's a great concept, but it's more of a niche solution that usually doesn't fit very well. Some of the practical hiccups include:
-Health issues in the group and the state risk pool rules/rates: My state is very favorable as far as the risk pool is concerned, but the state threatens against terminating a group to put participants in the risk pool.
-Discrimination rules: It would be great if you could terminate a group and have every employee purchase the same individual policy and reimburse them for exactly what their premiums cost. However, it has to be an equal amount for every employee or an equal % of compensation. Therefore, the premiums go much further for a 20 year old than a 55 year old. Yes you can get creative as far as segregating "classes" of employees, but it doesn't always work. This alone has been the main road block for me.
I find the concept typically works best for smaller, healthier groups with most employees being similar in age. I read this post this morning, but I decided to make a comment after I got off the phone with a client that we used this concept for two years ago. It has worked great for him as one employee got cancer this last year and he missed the huge table increase that would have happened had he kept the group plan, but unfortanetly I still have to resell him on it each year.
Plus, there is more service work involved. Every time an employee hits an age increase or their individual plan premiums go up (which happens at different points in the year as different employees have different carriers), the Sect. 125 plan amounts need to be changed. The employer usually doesn't have a clue, so it's up to the broker to assist and it does take a little extra hand holding. The good part of all this, the group is extremely tough to steal by the competition.
cdpowell
New Member
If I had to learn the group health market over again, I would contact a General Agent that represents multiple companies. I would attend agent training meetings for each of the carriers, meet successful producers and pick their brains. Some will be helpful, some not. Certainly the General Agent will be able to help answer questions.
K
karenabcde
Guest
Easiest way is this:
l. Get a company census. This is the only hard part of the job. Customers think this can be done without a census. It can't. You have to get a list of employees and ALSO if the employee has one or more spouses and/or children....hey this is 2008...we never know how many spouses there can be, right? We need to know if the spouse is covered under their employer plan or not. Find out HOW MANY kids there are. Next to the employee name, write down if they are male or female....no joke ---I know this sounds stupid.
Send the census in to your companies of choice. Get the quotes back from them. The carriers will call you and work out the quote with you. They will help you understand their plans. That is their job.....to be sure you understand the plan so you can sell it....some of them will go out and sell it for you.....no charge.
Now that you have the quotes back, make a spreadsheet. On the top of the spreadsheet label your companies you will be comparing-for example, Blue Shield, Aetna, etcetera.
On the left side of the page in a column, list all the benefits listed in one of your companies----say Aetna-----e.g. Deductible, copayment, mental health benefit/inpatient, outpatient, maximum days for mental health, prescription copayment, etcetera. This list should have 30 to 50 items in it....(or if you're in California, closer to 400,000 items.)
Then fill in the boxes and you have yourself a spreadsheet. If you can't fill in the boxes, call the carriers and ask them what goes in their box. Now you stack up all the proposals the carriers sent you...make a big pile....and go see the prospective customer. Go over the spreadsheet with them and carry in the pile of stuff. Tell them you have read all the stuff and it is summarized on the spreadsheet. Tell them the reputation of the carrier is ultimately important and they will look at the prices at the bottom of the spreadsheet and they will pick a plan.
Then you leave the customer a pile of individual enrollment materials or you can do the enrollment yourself or the carrier will help you. You fill out the master application with the customer and collect one month's premium check. Give all this to the carrier and they will go from there with you. All the while keep in contact with the carrier.
l. Get a company census. This is the only hard part of the job. Customers think this can be done without a census. It can't. You have to get a list of employees and ALSO if the employee has one or more spouses and/or children....hey this is 2008...we never know how many spouses there can be, right? We need to know if the spouse is covered under their employer plan or not. Find out HOW MANY kids there are. Next to the employee name, write down if they are male or female....no joke ---I know this sounds stupid.
Send the census in to your companies of choice. Get the quotes back from them. The carriers will call you and work out the quote with you. They will help you understand their plans. That is their job.....to be sure you understand the plan so you can sell it....some of them will go out and sell it for you.....no charge.
Now that you have the quotes back, make a spreadsheet. On the top of the spreadsheet label your companies you will be comparing-for example, Blue Shield, Aetna, etcetera.
On the left side of the page in a column, list all the benefits listed in one of your companies----say Aetna-----e.g. Deductible, copayment, mental health benefit/inpatient, outpatient, maximum days for mental health, prescription copayment, etcetera. This list should have 30 to 50 items in it....(or if you're in California, closer to 400,000 items.)
Then fill in the boxes and you have yourself a spreadsheet. If you can't fill in the boxes, call the carriers and ask them what goes in their box. Now you stack up all the proposals the carriers sent you...make a big pile....and go see the prospective customer. Go over the spreadsheet with them and carry in the pile of stuff. Tell them you have read all the stuff and it is summarized on the spreadsheet. Tell them the reputation of the carrier is ultimately important and they will look at the prices at the bottom of the spreadsheet and they will pick a plan.
Then you leave the customer a pile of individual enrollment materials or you can do the enrollment yourself or the carrier will help you. You fill out the master application with the customer and collect one month's premium check. Give all this to the carrier and they will go from there with you. All the while keep in contact with the carrier.
- 596
karenabcde,
Good post for outlining the process. One major thing before you do all of that, make sure the business is willing to work with you if you can help them. Below can be a lot of work to find out the owner's brother in law is their current broker.
Good post for outlining the process. One major thing before you do all of that, make sure the business is willing to work with you if you can help them. Below can be a lot of work to find out the owner's brother in law is their current broker.
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