How many of your clients MAPD plans are being dropped?

[axeman462]

humana took MOOP to 9350 in Ga

I have a hard time relating to that.
In Florida the average MOOP on a PPO is around $6,000. On an HMO is often under $5,000, even under $3,000 is not hard to find.

Do you have yourself any good HIPs you can offer?

 

[somarco]

small % people in their lifetime i would suspect hit a 7000 MOOP,

The only time it matters is when YOU are the one that has to pay for it.

Frankly, if you are selling based on how many MAY hit the OOP max you are completely missing the boat.

There are enough people that will hit $3k+ to make the ceiling a concern.

 

[DonP]

I’ve read several times only 4% hit the moop

 

[just-a-client]

these folks love that wayyyyyyyyyy over-priced OTC out of catalogues, why Humana would cut that out completely on some plans is head-scratching as they are losing clients because of it. $40 of that over-priced OTC is really only worth $15-----get that stuff at Dollar Tree for 1.25

I've wondered about the OTC. Out here in California, a number of supplements have so-called "innovative benefits" (vision, hearing, OTC, sometimes personal emergency devices, nurse lines, Silver Sneakers...). My supplement has no such extras.

I figure if I was able to use all those innovative benefits, it could make the plan practically free. But then - would I use many of them? And, what's the quality and actual value of the extras? Details are skimpy.

For OTC, the only details I've ever seen was indeed a catalog from Blue Shield of CA. (It wasn't that easy to find.) It's not like you could walk in and buy qualifying stuff from any pharmacy, like with an FSA. And the catalogs are totally generic - they don't list brands.

Sure, I'd be fine with generic ibuprofen, but what exactly are "bandaids"? I like the flexible kind, and don't like the CVS generics. Many kinds are on the market - obviously because people actually do have preferences!!

And, they have contact lens disinfecting solution. What kind?? They aren't interchangeable. Etc., etc. etc.!

And if it's all incredibly overpriced, you'd use up the OTC allowance in no time, making it nearly worthless.

So, I keep an eye on this but have stuck with my supplement each year during my birthday rule period. Its premium is still in the top 2 for my age - if I ignore the value of the innovative stuff.

(And I guess just like MAPD, they can discontinue those extras at any time. Blue Shield already closed down their "G Inspire" plan that was just a few years old, which was very popular - their deal with AAA offering a free annual membership was discontinued. However - at least from what I was able to find, they graciously allowed everyone from Inspire into their "G Extra" plan, which was similarly priced and had all the other same extras.)

I guess part of my question then is, is OTC always handled in that crappy user-unfriendly way? Picky people should stay away, then.

And, is it true in some states agents can't discuss innovative benefits when selling plans?

And, do you factor any of these benefits into your thinking, or are the only concerns rates, rate history and stability, insurer quality, keeping plans open, etc.? I suppose if you found 2 plans very similar in all of those respects, the extras would certainly be a tie-breaker.