New BlueCross "SMART SENSE" in Cali

Dec 2, 2007

  1. insuremojo
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    insuremojo Super Genius

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    Hey guys,

    Just got this from my RSM and wondered if you guys have seen this yet.
    Just after glancing I think overall it's a good plan but could be even better if it included maternity and had an 80/20 coinsurance option.

    Any thoughts, opinions?

    http://www2.bluecrossca.com/pdf/agent/SmartSense FINAL.pdf
     
  2. somarco
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    somarco That Medicare Guy

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    First Right Plan, then Tonik, now this.

    What's the big deal about 70/30 vs. 80/20? Either way you still have $2500 OOP after the deductible. I never understood that way of thinking.

    ER benefit is weak, at least compared to other BX plans with an ER copay then 100%.

    It does not say that preventive is covered without first applying the deductible. If deductible applies this is a major change away from other BX plans. That would mean the only first dollar benefits are 3 doc visits.

    I see quite a few things to bitch about other than maternity. If pricing is low (like they did with RP & Tonik) then expect first renewals to hammer the insured.

    I am seeing my first Tonik renewals and they are coming in at 30%+. I wrote a fair amount of RP when it first came to GA. I don't have anyone left on it any more. They priced it off the charts on renewal and new biz as well.

    I don't see anything exciting about it, but I dont work the CA market. Maybe I am missing something.
     
    somarco, Dec 2, 2007
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  3. Soaringagent
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    Soaringagent Guru

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    It seems like it's going to be popular in California for people that want a low deductible with a low out of pocket max... but don't need maternity benefits. Has anyone run quotes yet to see how it compares to other health insurance plans?
     
  4. insuremojo
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    insuremojo Super Genius

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    Thanks for the responses guys,

    Looks like rates will be good.

    35 year old single can get a $500 deductible for $91 dollars a month standard. Not too shabby. $1500 deductible for $75 dollars a month.

    Healthy check is still included as an up front benefit and a good feature in my opinion is the 4th quarter carry-over deductible feature. Also has embedded deductibles.

    Renewals probably will price out a lot of people but at least there's a plan for the market that might not be able to afford health insurance otherwise.

    I like this plan better than Vital Shield from BlueShield and it's pretty similarily priced.
     
  5. wildcat
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    wildcat Super Genius

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    Cross is getting pretty aggressive with the Smart Sense and the new Lumenos HSA & HIA (no maternity) plans.

    My RSM says sales have been flat for the past year and BC wants back in the fast lane.
     
    wildcat, Dec 3, 2007
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  6. MHart
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    MHart Super Genius

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    According to my RSM is filled a gap in their plans. When people wanted family coverage they could really only get Lumenos, HSA 3500 or PPO Share. Some families don't like HSA's and some don't need maternity that is where the smart sense will come in. Also they are marketing for this to get a lot of uninsured people in the 30 to 50 year old range.

    MY RSM also told me it was designed to beat the Aetna 2500 MC which is the most popular plan by them. He told me Aetna is the # 2 company in california right now.
     
    MHart, Dec 3, 2007
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  7. Soaringagent
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    Soaringagent Guru

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    The Smart Sense seems like it's going to be popular with clients. The rates are great for people shopping health insurance for a low deductible plan.

    Has anyone sold one yet?
     
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