Lasso MSA

bpenn9

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Utah
So Lasso Healthcare is coming out with a MSA a handful of states. Supposedly no networks, MSA pays provider until their high deductible is met. It seems as if the provider chooses not to bill them (most if not all will have not heard of Lasso Healthcare) it would be their choice. I like the idea of the MSA plan but seems like a provider nightmare and provider would need to be educated by patient and or agent.
 
So Lasso Healthcare is coming out with a MSA a handful of states. Supposedly no networks, MSA pays provider until their high deductible is met. It seems as if the provider chooses not to bill them (most if not all will have not heard of Lasso Healthcare) it would be their choice. I like the idea of the MSA plan but seems like a provider nightmare and provider would need to be educated by patient and or agent.
Brian,
A few comments here to hopefully clarify on Lasso and MSA:
You said that the MSA pays the provider until the deductible is met. It's actually the other way around, the member pays the provider until the deductible is met (with the help of the deposit), then the Health Plan pays 100%. I know that is what you meant to say that, but I didn't read it that way.
Regarding the clinical access piece:
MSA plans are truly non-network and work like as Original Medicare in that any provider that accepts Medicare and is accepting new patients must accept MSA plan members.
We did confirm with CMS this clinical access piece. It's different than PFFS, HMO-POS nor OON PPO with regard to access rules.
I agree completely that there still will be issues with providers for a variety of reasons and education will be required. We get this concern at a deep level and this will be a challenge we need to overcome.
The ID cards and website will have very clear instructions for providers and members along with a provider support number to call with questions.
All members will receive a 1-page document on how MSA works to share with the providers.
MSA is a low-revenue niche that virtually no insurers get excited about. I helped start the company because I have passion for the product and I wanted to see it as an option for Medicare beneficiaries. I also wanted agents to be the ones to market it as a part of their portfolio of options.
 
Brian,
A few comments here to hopefully clarify on Lasso and MSA:
You said that the MSA pays the provider until the deductible is met. It's actually the other way around, the member pays the provider until the deductible is met (with the help of the deposit), then the Health Plan pays 100%. I know that is what you meant to say that, but I didn't read it that way.
Regarding the clinical access piece:
MSA plans are truly non-network and work like as Original Medicare in that any provider that accepts Medicare and is accepting new patients must accept MSA plan members.
We did confirm with CMS this clinical access piece. It's different than PFFS, HMO-POS nor OON PPO with regard to access rules.
I agree completely that there still will be issues with providers for a variety of reasons and education will be required. We get this concern at a deep level and this will be a challenge we need to overcome.
The ID cards and website will have very clear instructions for providers and members along with a provider support number to call with questions.
All members will receive a 1-page document on how MSA works to share with the providers.
MSA is a low-revenue niche that virtually no insurers get excited about. I helped start the company because I have passion for the product and I wanted to see it as an option for Medicare beneficiaries. I also wanted agents to be the ones to market it as a part of their portfolio of options.
Thank you, I was hoping you would clarify. I plan to be on your webinar today. I am sure it's a good fit for some.
 
Craig,

Love the concept, and product. Availability has been the issue.
I applaud you for solving that problem.
Built my business on the HSA, and believe you may see this as the beginning of a big trend again.

I don't sell MA, and this product actually makes me reconsider that decision.
Mainly due to the any Medicare doctor option, the backbone of OM.

I can really see this as an alternative to Plan F / G / N clients as they age and get priced out of the market. Save $2400 in premium + $2550 MSA = most of your deductible, and have first dollar coverage from any doctor ($1 - $4950 due to savings above) vs $6700 - 8700 deductible

What is the reason why Florida does not have the Lasso option?
Is it the state dynamics? Or, are you still waiting for approval?
I assume this MSA, being an MA, allows for a trial right option, and GI back to med supp.?
 
Last edited:
I assume this MSA, being an MA, allows for a trial right option, and GI back to med supp.?

I asked that question and was told it does allow trial right. In that scenario, you lose your supp commission when you GI them back, correct?
 
Craig,

Love the concept, and product. Availability has been the issue.
I applaud you for solving that problem.
Built my business on the HSA, and believe you may see this as the beginning of a big trend again.

I don't sell MA, and this product actually makes me reconsider that decision.
Mainly due to the any Medicare doctor option, the backbone of OM.

I can really see this as an alternative to Plan F / G / N clients as they age and get priced out of the market. Save $2400 in premium + $2550 MSA = most of your deductible, and have first dollar coverage from any doctor ($1 - $4950 due to savings above) vs $6700 - 8700 deductible

What is the reason why Florida does not have the Lasso option?
Is it the state dynamics? Or, are you still waiting for approval?
I assume this MSA, being an MA, allows for a trial right option, and GI back to med supp.?
Thanks! FL is tough and we did not apply there. CMS does not allow for expansion for a new plan for 2 years, so we'll make an expansion decision by early next year for 2021.
The trial right option would apply, like any MA.
 
I asked that question and was told it does allow trial right. In that scenario, you lose your supp commission when you GI them back, correct?
The trial right is a GI, so that would certainly impact commissions. It's possible they could be underwritten, but unlikely. The trial right lasts for 12 months, so this protection is limited.
 
Craig,

Love the concept, and product. Availability has been the issue.
I applaud you for solving that problem.
Built my business on the HSA, and believe you may see this as the beginning of a big trend again.

I don't sell MA, and this product actually makes me reconsider that decision.
Mainly due to the any Medicare doctor option, the backbone of OM.

I can really see this as an alternative to Plan F / G / N clients as they age and get priced out of the market. Save $2400 in premium + $2550 MSA = most of your deductible, and have first dollar coverage from any doctor ($1 - $4950 due to savings above) vs $6700 - 8700 deductible

What is the reason why Florida does not have the Lasso option?
Is it the state dynamics? Or, are you still waiting for approval?
I assume this MSA, being an MA, allows for a trial right option, and GI back to med supp.?

There is a problem with your logic here. If clients are "priced out of the market" for certain medigap plans, the equivalent of those premium dollars is not available to them for coverage of medical costs, so there is still a big coverage gap for serious medical costs in a given year or back to back pair of years.
 
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