I'm Wondering if There Will Be a Place for the Agent in Trump Care?

[Key2Success]

They are in many locations but not this one. The individual bought strictly on price without understanding that he was buying a very restricted network. He had the exact plan available with a perfectly fine network but because he isn't an agent and didn't ask bought wrong. That wasn't Ocare's fault. It was his.

We had 2 major problems before Ocare's. People couldn't pass underwriting and premiums increased every year. Ocare took care of underwriting. The issue now is premiums which is a function of price and utilization. The primary driver of utilization in Ocare is participation and adverse selection.

The current proposals address utilization by going back to various forms of restricting coverage via trusts/ associations which is underwriting. Underwriting is only a form of price competition. The cleaner the group, the lower the price. Farm Bureau is a perfect example. Stricter underwriting on same plan and network had lower rates than BCBST direct. This was the case for years and years.

Two ways to deal with premiums. Reduce numerator (claims) or increase denominator (participation). Current proposals are numerator focused and the people who are the denominator and left out got mad. Repubs discovered they have to give lip service to pre-ex and underwriting.

Another big issue is procedure price increase that will sink the ship regardless of what happens in the next few years. Price controls aren't efficient and there are no market forces when insurance is the primary way of paying.

I'd prefer we address denominator then work on procedure price but expect we don't have enough nerve to enroll everyone and Congress makes too much money off lobbyists to address price.

LOL.....speaking of lip service....

Wake up and smell the coffee!

 

[junkman]

LOL.....speaking of lip service....

Wake up and smell the coffee!

Guess you've never taken business by doing what the incumbent agent didn't. It's easy. Find a lazy agent's group that has poor participation. Simply modify benefits a little, quote and enroll everyone. It cuts the rates drastically. The entire group has coverage for only slightly more than the failing group with prohibitively hi premiums. You have new money direct to your bank account.

Try beating a carrier down on a large group renewal. You'll learn the details of how rates are composed. TN had a 62% rate increase last year. We know that trend is only 8-10%. The only way to justify 62% is: 1. underestimating the prior year's claims and 2. poor and declining participation with inherent adverse selection. The calcs are simple arithmetic apparently not understood.

I'll be with 10 to 15 people later today. Some are in their 40s. Most are over 50. All can afford to buy insurance. All are healthy enough to pedal their bike at least 40 miles on any given day. None could pass individual underwriting. So, physically fit people with money can't buy insurance???? That is a problem.

 

[Key2Success]

Guess you've never taken business by doing what the incumbent agent didn't. It's easy. Find a lazy agent's group that has poor participation. Simply modify benefits a little, quote and enroll everyone. It cuts the rates drastically. The entire group has coverage for only slightly more than the failing group with prohibitively hi premiums. You have new money direct to your bank account.

Try beating a carrier down on a large group renewal. You'll learn the details of how rates are composed. TN had a 62% rate increase last year. We know that trend is only 8-10%. The only way to justify 62% is: 1. underestimating the prior year's claims and 2. poor and declining participation with inherent adverse selection. The calcs are simple arithmetic apparently not understood.

I'll be with 10 to 15 people later today. Some are in their 40s. Most are over 50. All can afford to buy insurance. All are healthy enough to pedal their bike at least 40 miles on any given day. None could pass individual underwriting. So, physically fit people with money can't buy insurance???? That is a problem.

Well of course you will! And no, that's not true. And BTW....I have a meeting with the President later today!

 

[nylife11023]

You keep thinking that, and stay out of our business. I bet you don't think people will pay consulting fees for health insurance advice either. What do your "metrics" say about that?

Never mind.

The inputs to establishing the metrics are simple:

What state DOI is going to be the first to let you charge consulting fees?

How many will follow?

Do you really think you will be allowed to set your own rates?

Finally, when the insurance biz catches up with technology such that buying health insurance will be as easy as buying shirt or skirt on Amazon, who is going to pay your fees? What is the customer incentive or motivation?

Come up with answers to those questions and I'm sure we can build a model.

You have been in the business for a long time and you know a lot about the past.

It is the future you should be concerned about.

Sigh, you are right.

Never mind.

 

[Yagents]

The inputs to establishing the metrics are simple:

What state DOI is going to be the first to let you charge consulting fees?

How many will follow?

Do you really think you will be allowed to set your own rates?

Finally, when the insurance biz catches up with technology such that buying health insurance will be as easy as buying shirt or skirt on Amazon, who is going to pay your fees? What is the customer incentive or motivation?

Come up with answers to those questions and I'm sure we can build a model.

You have been in the business for a long time and you know a lot about the past.

It is the future you should be concerned about.

Sigh, you are right.

Never mind.

Go crawl back in your hole. Here's proof of your ignorance on the subject:

FL passed fee law in April 16' http://laws.flrules.org/2016/202
AZ just passed fee law HB2279
Many other states reacted to the collapse in access to professional advice and are now allowing fees.

What you don't seem to realize is when you're dealing with someone's health and money, and they pay a fee for advice, they'll usually make it back 10 fold.

 

[taterpeeler]

And don't forget YAgent that the messiah said buying health insurance was like buying a plane ticket... amazing how that worked out...

 

[Higru]

The inputs to establishing the metrics are simple:

What state DOI is going to be the first to let you charge consulting fees?

How many will follow?

Do you really think you will be allowed to set your own rates?

Finally, when the insurance biz catches up with technology such that buying health insurance will be as easy as buying shirt or skirt on Amazon, who is going to pay your fees? What is the customer incentive or motivation?

Come up with answers to those questions and I'm sure we can build a model.

You have been in the business for a long time and you know a lot about the past.

It is the future you should be concerned about.

Sigh, you are right.

Never mind.

Good point NY Life.
Has anyone paid attention to healthcare profits? Seems to tell a different story. Commissions were cut because of the 80/20 rule and the agents pay fell on the 20 side. What about rebates to customers?
Drug companies are left out of many discussions, and a major contributors of premium cost.

 

[junkman]

And don't forget YAgent that the messiah said buying health insurance was like buying a plane ticket... amazing how that worked out...

It is like buying an airline ticket. The guy that flew United is like the guy that bought a narrow network and couldn't find any docs. They shoulda talked to an agent that knew something.

 

[Key2Success]

It is like buying an airline ticket. The guy that flew United is like the guy that bought a narrow network and couldn't find any docs. They shoulda talked to an agent that knew something.

Last call for alcohol!

 

[junkman]

Good point NY Life.
Has anyone paid attention to healthcare profits? Seems to tell a different story. Commissions were cut because of the 80/20 rule and the agents pay fell on the 20 side. What about rebates to customers?
Drug companies are left out of many discussions, and a major contributors of premium cost.

Carriers have lived with a 80% loss ratio for years. Where do you think that number came from - the carriers gave it to them? The problem came in when other things got thrown into the loss ratio calcs.

Most of the people here understand RX and the rapidly inflating prices and utilization. No need to pull RX out for most of the discussions because they are just claims and reflected in premium. Getting lobbyists out of Congress would be helpful.

TN commissioner said a TX company is looking at moving in ....if they can get networks worked out (by June). Good luck. Newby moving in renting networks and competing against BCBST S network? Perhaps Blues will just hand them the state????