Gap Plans

[GreenSky]

Since Obamacrap doesn't mandate that a gap plan would be issued GI without pre-ex, how would any company offer this without worrying about adverse selection?

I would think that the premium would be too high to provide any real value. Except to the agent selling it.

Rick

 

[healther]

Since Obamacrap doesn't mandate that a gap plan would be issued GI without pre-ex, how would any company offer this without worrying about adverse selection?

I would think that the premium would be too high to provide any real value. Except to the agent selling it.

Rick

Underwriting? The gap plan wouldn't be subject to the GI, as you said, therefore, it can be underwritten.

 

[GreenSky]

Underwriting? The gap plan wouldn't be subject to the GI, as you said, therefore, it can be underwritten.

Exactly. Therefore only the healthy would buy it and probably rarely use it. The poor couldn't afford it, the rich don't need it.

I can't see how this would provide value if only healthy people can qualify.

Rick

 

[FLM2]

There are times where using supplemental plans like Accident, CI and HI make a great deal of sense because it lowers premiums while reducing out of pocket for the most likely situations.

There is no 100% panacea that will always cover the deductible, that just doesn't exist.

I have had many clients thank me over the years for recommending that they get an accident plan, particularly those with children, but it's always up to the client.

Cigna has a Silver plan in Florida with $0 deductible and a $2500 per day copay in the hospital, the cost of that plan plus a $2500 Medico HI plan (upon admission, 3X per year max) is 10% less than a Platinum plan, that to me is a good combination offer, particularly if the client is in the 50-64 age band.

 

[healther]

Exactly. Therefore only the healthy would buy it and probably rarely use it. The poor couldn't afford it, the rich don't need it.

I can't see how this would provide value if only healthy people can qualify.

Rick

Not all healthy people are rich.

 

[GreenSky]

Not all healthy people are rich.

I'm not sure what you are trying to point out.

Not all athletes are stupid.

Your turn.

Rick

 

[healther]

I'm not sure what you are trying to point out.

Not all athletes are stupid.

Your turn.

Rick

The hybrid combination of a HDHP community-rated (essentially stop-loss) coverage and underwritten (out-of-pocket GAP) coverage could create a value option compared to a community rated plan with the same benefits.

Again, assuming the family is healthy.

This formula is the reason why self-funded plans are beginning to penetrate small to medium size groups. By-passing the community rated products are the best way to differentiate your offerings from your competitors, IMO. Your welcome.

 

[Yagents]

if a gap plan is NOT condition specific (accident / critical illness), then it negates the ability to fund a tax deductible HSA.

 

[AllenChicago]

The 23% of Americans who are now "Under Insured" are justifiably complaining that the $6,800 indiv / $13,600 family OOP presents a hardship. That 23% figure represents a lot of voters..

Ref: For Many, Obamacare Is Becoming The Unaffordable Care Act - Forbes

The government could make the next move to "Single Payer" by offering the equivalent of Medicare Supplements for the Under-65 crowd. True GAP filler policies. Naturally, taxpayers would foot much of the bill, either through private company reimbursement, or a straight government program, like Medicare.

 

[scagnt83]

if a gap plan is NOT condition specific (accident / critical illness), then it negates the ability to fund a tax deductible HSA.

One could argue that a Gap plan negates the need for a HSA to a large extent.

But could they not just have general "illness" instead of critical illness and still qualify for a HSA? For many families with kids a general illness benefit would be much more useful than critical illness. Especially since you can get an accident & CI policy for around the same price or lower than a Gap plan.

----------

Exactly. Therefore only the healthy would buy it and probably rarely use it. The poor couldn't afford it, the rich don't need it.

I can't see how this would provide value if only healthy people can qualify.

Rick

It would provide value to healthy families with kids. Healthy kids still get minor illnesses that need medical care. It would be a true middle class family type product/market.

----------

This formula is the reason why self-funded plans are beginning to penetrate small to medium size groups. By-passing the community rated products are the best way to differentiate your offerings from your competitors, IMO. Your welcome.

Assurant has been pushing self-funded for small groups recently. If I remember correctly they are even providing built in stop-loss coverage. And it is RX only UW for anything over I think like 20 employees. Interesting product, but with a group that small it seems that 1 large claim could blow the premiums sky high on renewal... maybe I am wrong.