ASO Plans for 50-99

[ABC]

I am starting to see the development of the ASO plans for groups 50-99. I do believe these plans will be very successful. It also going to show the employers the cost of claims. It will be interesting to see where the stop loss rate is going to be at. I think we could see these plans designs down to 25 lives.

I know TPA's have set up these plans for a long time but now its the major carriers that are developing them for small groups.

 

[stuy119]

Some stop-loss now is going as low as 35 that I've spoken with.

There will be a major shift coming between the have's and have not's in the health insurance world, mainly brought on by PPACA.

 

[ABC]

Some stop-loss now is going as low as 35 that I've spoken with.

There will be a major shift coming between the have's and have not's in the health insurance world, mainly brought on by PPACA.

Is the 35 for aggregate or specific?

"Have's and have not's"
Are you referring to carriers or consumers?

My feeling is if the big carriers go after the small ASO biz they could wipe out most of the remaining TPA's

 

[stuy119]

Both.

Have and have nots refers to the businesses purchasing/offering health insurance. Pretty soon it will be a system where the better companies offer private ASO plans, and everyone else will be getting government healthcare and Soylent Green (a slight exaggeration, but apt).

 

[ABC]

If we see plan designs with a agg of 35 I think I can sell that all day long. Because in the near future it might be very easy for a group to remove risk.

I think we have to wait and see what the exchange cost is going to be. Kaiser has released some estimates and they are way high.

 

[ASO Wonk]

Great-West sold small group ASO plans for years that worked pretty well. Problem comes with pressure on stop loss premiums and admin costs to the point where fixed costs are very high and the customer can't win on claims.

 

[leevena]

I am starting to see the development of the ASO plans for groups 50-99. I do believe these plans will be very successful. It also going to show the employers the cost of claims. It will be interesting to see where the stop loss rate is going to be at. I think we could see these plans designs down to 25 lives.

I know TPA's have set up these plans for a long time but now its the major carriers that are developing them for small groups.

This has actually gone on for quite some time now, but since the impact of Health Care reform, we are seeing more need to do this type of product. If a broker wants to stay in the medical market, self-funding becomes more attractive.

We wholesale benefits through brokers, and I am developing a self-funded program for 50-500 with a launch date of 1/1/2011. We are also working on a option for 2+ which will launch a little later.

With the right mix of stop-loss, data, analytics, cost controls, etc., these types of arrangements work very well.

Good luck.

 

[ABC]

Great-West sold small group ASO plans for years that worked pretty well. Problem comes with pressure on stop loss premiums and admin costs to the point where fixed costs are very high and the customer can't win on claims.

I use to sell Great West. They did some shady stuff. They use to not charge for the firsts month premium and then hold that over a clients head when they tried to leave. Also their rates went bad. I am not quite sure what happen. Couple of years ago Cigna bought them and was going to go after the under 100. Last time I checked their rates were very high.

This has actually gone on for quite some time now, but since the impact of Health Care reform, we are seeing more need to do this type of product. If a broker wants to stay in the medical market, self-funding becomes more attractive.

We wholesale benefits through brokers, and I am developing a self-funded program for 50-500 with a launch date of 1/1/2011. We are also working on a option for 2+ which will launch a little later.

With the right mix of stop-loss, data, analytics, cost controls, etc., these types of arrangements work very well.

Good luck.

I really don't understand how you can self fund a group under 10 lives? Is this more like split funding?

What kind of admin fees do you have on a self funded group this small?

 

[leevena]

I use to sell Great West. They did some shady stuff. They use to not charge for the firsts month premium and then hold that over a clients head when they tried to leave. Also their rates went bad. I am not quite sure what happen. Couple of years ago Cigna bought them and was going to go after the under 100. Last time I checked their rates were very high.



I really don't understand how you can self fund a group under 10 lives? Is this more like split funding?

What kind of admin fees do you have on a self funded group this small?

These groups cannot stand on their own (self-funding), so you need them to aggregate within a Captive, or some similar type of vehicle.

 

[somarco]

We are also working on a option for 2+ which will launch a little later

Contact me to discuss.

I really don't understand how you can self fund a group under 10 lives?

There was a firm in Atlanta that tried this a few years ago. Minimum group was 5 lives as I recall. Good concept but never felt comfortable with the people running the plan. I believe it folded within a couple of years.

Self funding smaller groups can be done but it is very difficult to accomplish. Perhaps bypassing all but federal mandates will help plus, at least for now, self funded plans are exempt from MLR.