Mini Med and High Deductible Plan Combo

[James]

I have more than one prospect looking into the CoverTN (mini med plans for small business in Tennessee, BC and it is a 1/3 split), yet I'm trying to educate them about the HDHP and HSA. Now the CoverTN Plan has a Max of 25 grand a year in benefits, obviously this leaves a Risk factor for those participating in these plans. Most of these type of prospects are coming from my prospecting on small groups to sell "Voluntary" plans too, mostly Life and DI policies.

I guess what I'm wondering is there a certain way to set these accounts up so the person recieves full credit that the Mini Med Plan pays to apply to the deductible of the HDHP or HSA. Most of these clients don't want to talk about HRA's, well I can create some interest once I bring up a FSA to help in Child Care and Communting Cost (Gasoline). Now that does seem to add some interest in going to the next step and setting up a HRA or FSA.

 

[somarco]

Your challenge is finding a carrier with a $25k deductible. If the group is large enough you can get a carrier to write a $25k specific stop loss and have claims xs of the SIR administered by a TPA.

I don't know any small group plans with deductibles that high.

Two carriers write individual policies with a $25k deductible. Time & World.

So you have limited choices.

 

[James]

You are right, my point though is not truly concern to group. The group will be getting their Mini Med via CoverTN, which the employer pays 1/3, State pays 1/3 and the employee pays 1/3. Now for a 35 year old that is about $32 dollars a month. So going back to each employee and suggesting a HDHP (on a voluntary basis), basically the Assurant Max Plan with a 25 grand deductible is inexpensive. For him the employee the Max Plan is around $52 monthly premium, if I include his wife (32) and two kids we are looking at $155 monthly premium, just an average of what I'm looking at.

Now this is saving everyone money! Plus Maternity can be added up to $10 grand for the women at a affordable rate, plus children would automatically be covered including all wellness visits at 100% coverage under CoverTN. I'm using this as a added benefit to the employer to give their employees credible coverage (which any Mini Med has serious flaws even if supported by the State which many seem to understand) they need if they decide to go with me.

Now I suggested this to only a few owners, just making sure this is feasible or if there is any specific way of setting this up to make sure that the Assurant Max HDHP will coordinate with the Mini Med which is a BC Underwritten Plan.

Ps, now if you add a spouse to CoverTN the Business does not have to contribute their 1/3, yet the ones I'm talking to are saying they will, so the premiums for CoverTN would be double $32, Child can be covered on their own plan for around $70 via Assurant if the family doesn't meet certain criterias set by CoverKids.

 

[somarco]

Each state defines creditable coverage. For instance, in GA STM is considered creditable but not so in other states. If the TN defines CoverTN as creditable then you are OK.

As far as coordinating CoverTN with the Time plan, there are 2 issues.

I am sure CoverTN has their own network which may or may not coincide with the Time networks. So you may have a participant who sees a par doc for CoverTN but that same doc is not in the Time network.

Also, Max has an Rx benefit that may conflict with the CoverTN benefit.

You can add a maternity benefit, but why bother unless it is not covered by CoverTN?

I would run it by Time just to see how they feel about superimposing over CoverTN. I tried to do something similar a few years back and World was the only one who agreed to make an offer.

 

[James]

Each state defines creditable coverage. For instance, in GA STM is considered creditable but not so in other states. If the TN defines CoverTN as creditable then you are OK.

As far as coordinating CoverTN with the Time plan, there are 2 issues.

I am sure CoverTN has their own network which may or may not coincide with the Time networks. So you may have a participant who sees a par doc for CoverTN but that same doc is not in the Time network.

Also, Max has an Rx benefit that may conflict with the CoverTN benefit.

You can add a maternity benefit, but why bother unless it is not covered by CoverTN?

I would run it by Time just to see how they feel about superimposing over CoverTN. I tried to do something similar a few years back and World was the only one who agreed to make an offer.

I don't sell CoverTN at this time, BC has direct online submission from what I can tell, but from what I can gather there is no "Network", they say you see any doctor you want so I'm assuming it's more of an "Indemnity Plan". The maternity benefit would be thru CoverTN, not assurant Max Plan, the maternity benefit tops out at 10 grand yearly with CoverTN.

Honestly, I have no desire to sell CoverTN. I'm thinking there may be better avenues for these arrangements but, since it is the State Subsidize and BC Plan, some just want it even after you tell them, there may be better solutions. Or maybe not!

 

[somarco]

The $10k CoverTn should be enough to cover normal delivery and most C-sections (with discounts). But if there are no networks there is no way to tell how much a provider will charge and how much is covered.

Without more details on CoverTn there is no way to really make a judgement call. Some folks will buy cheap even if it is crap.

 

[James]

As far as Mini Meds, Covertn seems okay, go here for benefits under the plan.

CoverTN

 

[somarco]

That's not a bad plan. They do have a network (Blue Card PPO). I would do just what you suggested. Push the CoverTN and write a $10k deductible on top.

If CoverTN blows up in a year or two at least you have a client base to go back & rework.

 

[Michelle Chase]

I can show you how to make this all work. if you would like to discuss please message me as I don't like to disclose information about the company's your working with. We could share the outcome. I have a solution!

 

[Northeast Agent]

I can show you how to make this all work. if you would like to discuss please message me as I don't like to disclose information about the company's your working with. We could share the outcome. I have a solution!
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Too little, too late. The post is years old.