Let's Challenge 'The Wedge' with This Case...

[2112Greg]

I can't recall who it was, but someone mentioned this book a week or two ago. So I stumbled upon a copy not of 'The Wedge' but of its counterpart/predecessor 'How to Get Your Competition Fired...etc.'

It's a pretty good read. I think there are some good techniques in there. I've already got most of the things that this book deems important.

So, I've got a wealthy prospect. 48F, 46M, two teenagers. Good health all, except for the wife. She's got Hashimoto's Hyperthyroidism and some rather complicated sinus issues which have required CAT scans, but not in the last couple of years. She takes Cymbalta for anxiety (for which there is no coverage on her current plan).

They have BCBS and pay 845 a month for 1500 ind/4500 fam deductibles with 3k/6k coinsurance, 25 dollar copays. She's the only one that ever gets close to the deductible. The kids and husband have no issues (n/s, ht/wt is fine, no significant medical history). They've had this plan for almost 4 years.

I met with the wife at their home. Our rapport was fine.

I made some recommendations (Golden Rule's HSA). She was leary of a family deductible.

Let's sell this one using 'The Wedge' techniques.

Anyone up for this game?

 

[somarco]

Hashimoto's Hyperthyroidism

Which is it?

Hashimoto's, which is a disease that causes hypothyroidism, or hyperthyroid?

Can't be both.

What are the "complicated" sinus conditions? Is surgery suggested?

Cymbalta is used for major depressive disorders. Sounds like there is more going on than just routine anxiety.

Move hubby and kids. Leave her alone. You may not be able to move her any way.

 

[VolAgent]

I'm confused, what exactly are you expecting The Wedge to do here?

It is all about separating your new client from his previous provider based upon lack of service. Is that an issue here? It sounds like you have some serious problems to overcome to her covered.

It is not designed to overcome shortcomings in product, or client product concerns. I'm not saying your product is bad, I'm just saying that you will have a hard time getting something to cover her, and her concerns over the family deductible.

Remember, it was written based on his experience with commercial P&C, and I believe some RRs. Generally in those lines, you can always take over accounts that you want. There aren't "health" issues to overcome.

 

[2112Greg]

Sorry, I didn't mean to sound like I didn't think the techniques didn't work. I'm very favorable to The Wedge. In fact, I like it a great deal. There is a good amount of rehashed information in there, as would be expected after the countless sales books that have been published.

What I was asking, albeit poorly, was how to solve this case using the techniques used in the book. I'm only about halfway through it (will probably finish it over the weekend) and I feel like now is where I've really started into the practical aspects of the book. In fact, I've skimmed most of the early portions...looking for the meat.

I've presented her with several scenarios. One leaving her on her on the BCBS policy, putting her on her own new plan and the rest of the family on their own HSA and then having them all on the same HSA.

I feel like I may not have all the information re: the sinus issue (what I've seen is sinusitis) and she told me 'anxiety' which is why she takes Cymbalta (have heard of this drug before, but not run across it in this capacity).

So if there is a wedge to be used here, I'm just looking to see how my normal sales process would be different by using it. If there is no wedge, then there is nothing but my normal process.

One aspect that I do like is the nature of the incumbent. That's my biggest foe here. So I feel like there is a REASON to have a wedge...just looking for what it is specifically.

The health issues are a big factor here. So it may just be a no brainer to leave her on BCBS. Now, how do I insert the wedge to get the kids and dad to move.

That's my question...

 

[ksigmtsu]

Cymbalta = uninsurable in most cases. It has a cost around 500 per month if you buy out of pocket. It also has nasty withdrawal symptoms for a lot of people.

 

[2112Greg]

I didn't know that about Cymbalta and I hadn't had time to look into it any further. She just mentioned 'anxiety' and I took her at her word and didn't look into it any more.

I'll win the case based on a few things they are trying to improve. If anyone has any advice, I'm always open.

Thanks!

 

[ksigmtsu]

Its the new prozac, doctors are prescribing it with no step therapy attempts to get their kickbacks from pharmacy reps, taking their patients pharmacy record and loading it with a drug that has costs so high they can't get insurance without a rider.

 

[somarco]

Cymbalta Information from Drugs.com

30 caps are $142/mo at carrier price. It is not so much the cost of the Rx as it is what the drug is used for plus all the contraindications.

Cymbalta is heavily advertised for people who have depression and their current medication is not "working". The DTC advertising encourages people to ask their doctor about Cympbalta.

Nothing unusual there, but you can bet a lot of folks who have a bad day and Lexapro isn't cutting it are asking for Cymbalta and the doc will easily roll over.

 

[VaDwayne]

Sorry, I didn't mean to sound like I didn't think the techniques didn't work. I'm very favorable to The Wedge. In fact, I like it a great deal. There is a good amount of rehashed information in there, as would be expected after the countless sales books that have been published.

What I was asking, albeit poorly, was how to solve this case using the techniques used in the book. I'm only about halfway through it (will probably finish it over the weekend) and I feel like now is where I've really started into the practical aspects of the book. In fact, I've skimmed most of the early portions...looking for the meat.

I've presented her with several scenarios. One leaving her on her on the BCBS policy, putting her on her own new plan and the rest of the family on their own HSA and then having them all on the same HSA.

I feel like I may not have all the information re: the sinus issue (what I've seen is sinusitis) and she told me 'anxiety' which is why she takes Cymbalta (have heard of this drug before, but not run across it in this capacity).

So if there is a wedge to be used here, I'm just looking to see how my normal sales process would be different by using it. If there is no wedge, then there is nothing but my normal process.

One aspect that I do like is the nature of the incumbent. That's my biggest foe here. So I feel like there is a REASON to have a wedge...just looking for what it is specifically.

The health issues are a big factor here. So it may just be a no brainer to leave her on BCBS. Now, how do I insert the wedge to get the kids and dad to move.

That's my question...

I'm not sure the wedge techniques are designed for this problem but I don't sell health insurance. The problem here is not "incumbent agent" issue, it is "health problem" issue, I think that's what I hear you saying..

 

[ksigmtsu]

I've never had an app with Lexapro go through either without a rider.