- 1,459
Thanks for the MN loss ratios attachment. Interesting, the carrier with the best rates had a 43% loss ratio and the one with the worst rates a 97% loss ratio and dominant market share. Go figure.
MLR Discussions
- Thread starter stuy119
- Start date
- 8,448
You are welcome, Full Throttle. I figure that since Blue Cross brings in so many dollars, that the 3% they spend on non-medical expenses is still more money than what many companies generate in total revenue. But also, BlueCross pays some of the lowest commissions and has no big trips or contests for the agents.
I don't have the chart open in front of me now, but I would assume that the company that spends 57% of their premium dollars on non-medical expenses has some top commissions, trips, highly paid employees and a low-tech/high-touch customer service area?
- 10,830
Its going to be hard to sell HI outside of the exchange.
To not incur the fine, the plan has to meet the criteria of being "qualified".
A "qualified" plan can be in or out of the exchange, but if its outside of the exchange it still has to be priced at the same rates as inside the exchange!
So the only chance of having a low cost plan will be a "non-qualified" HI plan, but you will have to tack the fine on top of the premiums, which will be at least a $100/month markup...
It seems that the only real future in HI will be in the group market (If businesses even keep group plans after the exchanges go into effect)
To not incur the fine, the plan has to meet the criteria of being "qualified".
A "qualified" plan can be in or out of the exchange, but if its outside of the exchange it still has to be priced at the same rates as inside the exchange!
So the only chance of having a low cost plan will be a "non-qualified" HI plan, but you will have to tack the fine on top of the premiums, which will be at least a $100/month markup...
It seems that the only real future in HI will be in the group market (If businesses even keep group plans after the exchanges go into effect)
- 3,863
Are you implying a fine will be $100/mo for buying outside the exchange? I disagree that virtually any fines will exist or ever be enforced. We are clearly heading to GI with no mandate.
- 15,041
With the premiums families will face, we will have to go that way. There is no way a family can afford 10k+ premiums unless the subsidy is advanced in some fashion. File your taxes and wait for it is not going to work for the vast majority of Americans.
And if we do end up that way, just wait for the tax refund sales! The merchants will go crazy trying to capture some of that money.
- 14,808
The subsidy will be advanced. You can't tell families earning 200% FPL to pony up 10K in premiums and wait until tax season.
We can see this in how they operated the 65% COBRA subsidy. The insured only paid the 35% - they didn't have to pay all of it and wait for a check.
We can see this in how they operated the 65% COBRA subsidy. The insured only paid the 35% - they didn't have to pay all of it and wait for a check.
If the numbers are to be believed, Blue is losing money on their block.
Also invalid reasoning. That carrier has found a niche market that is highly profitable and those profits are supporting other lines of business.
That is different.
The govt forced businesses to make an interest free loan/advance against tax credits to offset premium subsidies. In the case of small group, where carriers advanced the subsidy, the same scenario occurred.
Obamacrap is a nightmare that will not come anywhere close to living up to the promises, or working the way they planned.
- 14,808
Likewise, the gov't will force carriers to bill clients according to the discounted rate and "make it up" to them at some point in the future - be it tax credits or simply a check.
There is a zero percent chance this program will be implemented in 2014 if everyone under 400% FLP has to pony up the dough and wait until tax season. Zero.
There is a zero percent chance this program will be implemented in 2014 if everyone under 400% FLP has to pony up the dough and wait until tax season. Zero.
- 15,041
Exactly my point. There is no way a family of 4 making 60k a year can pay a $1,000/mo premium and wait for the government to reimburse them 600-800/mo.
- 14,808
Again, zero chance. There are not a lot of absolutes when dealing with this legislation but this is one of them. People will not have to cough up the dough and wait.
