Splitting up a large group. Is it legal???

Sep 22, 2007

  1. zackarychapple
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    zackarychapple Expert

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    Ok everyone here is a group health question. Lets say that I have a group of 15,000-20,000 people and I want to give them the best rates possible. Is it possible present different companies for different age groups.

    Example,

    ages 40-65 are cheaper with bcbs so I show them that

    30-39 health partners

    20-29 preferred one

    is that possible, I am making up ages for the breakdown but you get the general idea.

    can this also be done with group life and group DI??


    thanks for the help guys.

    Zack
     
  2. djs
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    djs Super Moderator Moderator

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    Your making this to complicated. At least in California, especially with a large group such as this, you can offer multiple carriers to the group and let them pick. You don't have to isolate choices per demographic.

    Normally, yes, you can do carveouts, but I don't think you can do them based on age. Again, you normally don't have to, offer all the carriers to each age, let them decide. This is done a lot usually offering a choice between a PPO and an HMO (Kaiser and BlueCross for example).

    I don't know about group life or disability. I've never seen a deal with multiple carriers offered, but that doesn't mean it couldn't happen. I also have no idea what the participation requirements would become for these.

    Dan
     
    djs, Sep 22, 2007
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  3. somarco
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    somarco GA Medicare Expert

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    I see no reason in splitting up a group of this size. It is credible as is and, unless they are operating in a vacuum, will be receiving the best rate possible based on plan design.
     
    Last edited: Sep 23, 2007
    somarco, Sep 23, 2007
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  4. Consultant
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    In California there's Calchoice: (offering Kaiser, Health Net, Blue Shield - a little more expensive (less requirements)). There's KaiserChoice if the company is mostly HMO and less than 25% want PPO. More affordable than CalChoice -but less choice.

    Moreover, you can split companies. Each company, i.e. Blue Cross, Health Net, Aenta, UHC has different participation requirements.

    Call Mary Landen at Benefit Mall @ 800-354-6926 ext.3213 (tell her Sean referred you - I don't want credit, just recognition :) ). Her staff can bound quotes and 1st class them to you the next day. (All Services Free) Her knowledgeable staff will be able to break down all the requirements and give suggestions in starting group sales. Good Luck!
     
  5. somarco
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    somarco GA Medicare Expert

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    OK, but why would you want to split up a 15,000+ life group? They already have a rate that is better than they can get from any small group plan.
     
    somarco, Sep 24, 2007
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  6. Mr. Bill
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    Mr. Bill Guru

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    Normally the employer sets a base for how much they're willing to pay, and gives all the employees all the options, then the employees who choose more expensive coverage pay for the difference themselves.
     
    Mr. Bill, Sep 29, 2007
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