Zero Deductible Health Insurance with Cash Back

[leftsided]

I go a step farther and offer a high deductible policy to lower premium dollars and with the money saved "wrap" a secondary indemnity policy around it to provide some outpatient benefits and help satisfy the deductible on the primary policy.

This is definitely becoming a more common option especially since employers are switching to higher deductible plans in the workplace. As ridiculous as this sounds, make sure the indemnity plan pays as assignable benefits, rather than out of pocket reimbursement.

A broker of ours came back to us with what a group was offering, and the "gap" plan they were using was 100% out-of-pocket reimbursement, kind of defeats the purpose when showing a client how these "gap" plans can save them money annually!

 

[somarco]

A broker of ours came back to us with what a group was offering, and the "gap" plan they were using was 100% out-of-pocket reimbursement, kind of defeats the purpose when showing a client how these "gap" plans can save them money annually!

Fully insured carriers are getting wise to this, something stop loss carriers noticed 20 years ago. When the carrier is aware of underlying HRA/HSA funded by the employer, or if there is a gap plan in place they are increasing their premiums to account for the underlying benefits.

When a high deductible is in place without some form of supplemental gap coverage insured become careful buyers. They utilize medical services only when necessary and look for lower cost alternatives such as doc-in-a-box and generics. When that risk exposure is removed with an employer funded spending account or a gap plan covered participants will reach their deductible much quicker and get into the carriers pocket.

 

[IAC.Ryan]

When a high deductible is in place without some form of supplemental gap coverage insured become careful buyers. They utilize medical services only when necessary and look for lower cost alternatives such as doc-in-a-box and generics. When that risk exposure is removed with an employer funded spending account or a gap plan covered participants will reach their deductible much quicker and get into the carriers pocket.

Depends on the type of gap plan. If you supplement a higher deductible plan with a good HIP or CI - I'd argue that the insured will likely remain just as engaged of a consumer as one without. Because its very difficult to over-utilize / take advantage of In-patient confinement or critical illness related benefits.

Personally, I only sell higher exposure plans with multiple layers of Gap's weaved in. The premise of - The major medical is the foundation, should you find yourself diagnosed with a critical illness or admitted to a hospital for some other major occurrence - these plans will take care of you. You just handle the small ticket items, and in return - you'll pay a lower premium. We'll take care of everything else.

 

[somarco]

This wasn't meant to be a debate, just fleshing out what the actuaries are doing on HDHP pricing.

As for "weaving in" several supp plans, it would seem the policyholder would find it confusing at claim time. Which policy covers this or that. Since major med is almost always filed by the provider and supp plans are not, my guess is many forget to file, don't know how to file, claims against supp plans.

Seems like a lot of extra work to me.

 

[johndale]

As long as they buy from me, I am not frustrated at all.

Yes, that's the idea and should be the strategy.

 

[somarco]

Spamming johndale?

 

[BlueChairMan]

We develop a plan for our clients that include accident and CI. Raise deductible. Lower premium. Add accident/CI to limit OOP expenses for the client. Most clients like the fact you keep them from high OOP expenses. Not every client takes all three but a majority take at least two. We know we offered the best way to keep their OOP expenses low.

This wasn't meant to be a debate, just fleshing out what the actuaries are doing on HDHP pricing.

As for "weaving in" several supp plans, it would seem the policyholder would find it confusing at claim time. Which policy covers this or that. Since major med is almost always filed by the provider and supp plans are not, my guess is many forget to file, don't know how to file, claims against supp plans.

Seems like a lot of extra work to me.

 

[HealthGuy]

To me, I see the beauty of selling a supplemental accident plan with a high deductible HSA, and maybe even a supplemental CI plan. Beyond that, I can't see any other supplemental coverages really making sense. For example, why would someone buy an additional supplemental cancer policy if you have a good CI policy? Just wondering.

 

[somarco]

Raise deductible. Lower premium. Add accident/CI

Actually, that is raise deductible, lower premium, raise premium.

If the client wants less exposure, let them buy a lower deductible. Of course with most low deductible plans, say $2500, their exposure is the same if they have coinsurance above the deductible as it would be with a $5,000 deductible 100% plan.

They may THINK they are buying more coverage but in fact they are not. They just get to pay more.

Those who buy a HDHP then backfill with supplemental plans don't really understand the concept of risk transfer and are mostly throwing their money away based on false assumptions.

I have yet to see a decent accident plan that is not overpriced. Perhaps you can enlighten me.

And most CI plans are fraught with holes, not to mention the individual who comes down with an illness that is not covered by the CI plan.

"Sorry you were diagnosed with ALS. Guess you will just have to suck it up and cover the deductible yourself."

Yeah, that's a conversation I want to have.

 

[YouGotMyMoney]

I have yet to see a decent accident plan that is not overpriced. Perhaps you can enlighten me.

I don't know what you consider to be priced fairly, but here are some numbers:

VBA 10k Family $65

GetInsured 10k Family $45

WBA 10k Family $47