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 ACA Health Care And Brokers - Comments By H&HS

The following articles are from Healthcare.gov - The official informational site for ACA provided by Health & Human Services.  The relevance of these different articles is that they all reflect a continuing role for brokers.


Today, small employers like you have a tough time finding and affording coverage that meets the needs of your employees. Starting in 2014, you’ll have more choice and control over your health insurance spending through the Small Business Health Options Program (SHOP), a new program designed to simplify the process of finding health insurance for your small business.

You control the coverage you offer

You choose the level of coverage you’ll offer, and define how much you’ll contribute towards your employees’ coverage.

Access to tax benefits

You’ll also have exclusive access to an expanded Small Business Healthcare Tax Credit. This tax credit covers as much as 50% of the employer contribution toward premium costs for eligible employers who have low- to moderate-wage workers.

When you get insurance through the SHOP, it makes it easy for you take advantage of other tax breaks too including the chance for you and your employees to use pre-tax dollars to make your premium payments.

New consumer protections

You and your employees will also benefit from new protections that help you get real value for your premium dollars. There are new limits on the higher premiums insurers can charge businesses with older employees, and an employee with high health care costs no longer increases your group’s premium. There are also new limits on the share of premiums going to insurers’ profits and administrative costs.

Insurance plans run by private companies

The health insurance plans available in the SHOP will be run by private health insurance companies, the same way small group plans are run now. All plans will offer the same benefits as a “typical” employer plan, including real protection against financial catastrophe.

Plans will present their cost and coverage information in a standard format, using plain language that’s clear and easy for you to understand. You and your employees will be able to easily compare plans based on price, coverage, quality and other features that are important to you.

Use your broker, or shop on your own

You can use your existing insurance broker to access the SHOP, or you can shop for plans yourself, without a broker. You can review pricing and coverage in apples-to-apples comparisons, complete a single application, and choose the level of coverage that works for your budget, your business, and your employees.

Watch for more information in October 2013

Starting in October, you’ll be able to get information about all the plans available in your area. You and your employees will be able to enroll through your broker, directly through the website, or by calling a toll-free phone hotline.

What role will agents and brokers play in the Exchange? Will they still help individuals and small businesses find and apply for health insurance?

Under the Exchange proposed rule, Exchanges will have flexibility to determine what role agents and brokers will play in the Exchange. The Exchange may choose to allow agents and brokers to assist consumers with applications for advance payments of the premium tax credit and cost-sharing reductions and enroll individuals, employers, and employees in qualified health plans. States will maintain their current role licensing and overseeing agents and brokers. In many States, we expect that agents and brokers will play a role working with individuals and small groups in the Exchange.

Checklist for Small Businesses:

If you’re a small business owner, you’ll be able to offer your employees new health plan choices through the Small Business Health Options Program (SHOP).

7 things you can do to get ready now


1.Make sure you understand how insurance works. For example, you’ll want to understand the difference between premiums and out-of-pocket costs, like deductibles and copayments. You’ll want to compare these details to help determine which plans are right for you and your employees. Visit Understanding Insurance to learn more about how insurance works.

2.Learn about different types of health insurance. Through the Marketplace, you’ll be able to choose a level of coverage that gives you and your employees the right balance of cost and benefits.

3.Start thinking about when to begin coverage. You’ll need to choose a month to start coverage. Consider what timing would work best for you and your employees.

4.Set your budget. Think about how much money you’re able to spend for group coverage. You’ll also need to consider how much your employees can spend for their coverage.

5.Get organized. You’ll want to have basic information about your business organized and available, like a list of employees you plan to cover and your tax ID number.

6.Make a list of questions you have before it’s time to choose which health plans you’ll offer. Consider what’s most important for your budget and your employees.

7.Look for help. If you already use a health insurance agent or broker, they’ll be able to help you figure out your options. Brokers sell many different insurance products and are usually paid by insurance companies. Agents work for just one insurance company.

 

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Remarkable - Every 17 Minutes

Every 17 minutes of the day, someone buys a life insurance policy.....and does not live to pay the second premium.  Most of us (yes even agents and brokers) are under or uninsured.   For those of you who specialize in health and or property casualty, not offering life insurance is both a disservice to your clients and a missed opportunity to increase your business.

At AMG, we have a number of programs available to help you with life insurance sales:

EZ Life

Our proprietary on line quote and application submission system that eliminates all the paperwork and still pays you full commission regardless of which carrier.   You can have your own custom link and marketing materials that can be emailed to your clients.

List Term

A new offering that is guaranteed issue at 25 lives (corporate paid but individual policies) and only 4 questions at 10+ lives.

Policy Assessment

Another proprietary program that offers a no cost review of your clients existing polices from an independent service. The report provided with address issues such as Is the policy in danger of lapsing prematurely, can your client increase coverage and/or reduce the cost of Current Coverage, and is your client's policy performing as expected?

If you are interested in learning about how you can make life insurance part of your sales process contact Steve Gresso  at 713.977.0611 or steve@affiliatedmarketing.com

 

No Changes Until December 2014
 
Affiliated Marketing Group
 
4800 Sugar Grove Blvd.,
Suite 350
Stafford, Texas 77477
Phone 713.977.0611
 

 

We Offer A Full Portfolio Of Products And Services

Group Medical

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No changes to small group major medical new business benefits or rates until December 2014

Keep your major medical sales strong all year long. For effective dates from April 1 to December 15, 2013, sell Assurant Health major medical plans and your clients' benefits and rates won't change for at least 12 months.

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Will not change, assuming no enrollment or benefit changes from the employer.

Look for more information on this as well as good news for your current major medical clients.

Contact Heather Matias Ainesworth for more information.

 
 

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EZ Life Sales

Our proprietary web based one page application that is the same for all carriers.

You can quote and submit our one page application in less than 15 minutes.

It is the easiest system available for writing  life insurance and best of all, you retain control of your case, have 24/7 status updates available and there is no reduction in commissions.
 

 

Plans Will Be Bare Bones - And Expensive

 

Another perspective on ACA

Written March 5, 2013 by Scott Gottlieb

 

There's mounting evidence that come fall, the health plans sold through the Obamacare exchanges will be bare bones affairs - with narrow networks of providers to select from, and heavy co-insurance once patients go "out of network."

In many ways these plans will be a throwback to insurance schemes of the late 1990s, when managed care was dominant and restrictive networks standard fare.

With one difference: The Obamacare plans won't be cheap.

Quality of coverage is just one issue. Price is the other. There's mounting evidence that even though the new health coverage will be austere, it'll still be pricey.

Health plans have ample incentives to price the Obamacare coverage high, which is precisely what they're likely to do.

For one thing, insurers will want to protect against the risk that individuals entering the exchanges are those who most need health insurance because of pre-existing illness. If this sort of "adverse selection" occurs, it will raise costs to insurers. To guard against this, insurers are likely to price the coverage at a premium.

Second, health plans want to reduce uncertainty around how all the risk-sharing provisions in Obamacare will eventually play out. The legislation puts in place mechanisms that forces Washington to share with health plans some of the cost of the covering the sickest beneficiaries. But the regulations outlining these parameters were only released last Friday. Nobody yet trusts how they'll work.

To mitigate uncertainty, plans will price their products high. Insurers know that any excess profits they earn will have to be paid back to the government, anyway (owing to caps that Obamacare places on how much profit health plans can earn). Health plans are better off aiming high, and owing money back, then getting underwater.

After all, Washington takes away "excess" profits, but it doesn't share in losses.

Third, health insurers will want to reduce the incentive for employers to drop coverage and dump employees into the exchanges. This is especially true when it comes to insurers' lucrative small group and large group segments.

If insurers price the exchange products too low, they'll give employers another inducement to do this sort of dropping. By pricing exchange products higher relative to the insurance offered in the private market, they reduce this incentive.

Finally, the providers that Obamacare plans must contract with are unlikely to offer significant price cuts to attract this volume. Since the Obamacare plans are likely to pay providers less than rates offered by standard private coverage (and maybe even less than Medicare rates) many doctors could also refuse to accept Obamacare, just like they refuse Medicaid. Or refuse to offer insurers discounts for these patients.

The architects of Obamacare designed the scheme without much thought to how its overlapping incentives would discourage competition on the price of the new coverage. Health plans will try to drive down costs by offering very narrow networks of providers that they can more easily control. It will be a race to the bottom to see which plan can offer the cheapest benefit, while still meeting minimum standards. But it won't be a race to the bottom on price.

Plans have too many reasons to price their products cautiously, and not automatically pass along any cost savings to consumers.

If the Obamacare plans are priced higher than initial assumptions made by the Congressional Budget Office, it will burst the estimates placed on Obamacare's total costs. It could also make these plans unappealing to consumers.

Economics turns on simple principles. They've evaded Obamacare's architects.

American Enterprise Institute (AEI) Resident Scholar Scott Gottlieb, M.D. is a practicing physician.  He previously served in senior positions at the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS). 

For Producer or Broker/Dealer Use Only. Not for public distribution nor intended to be used as financial or tax advice.