L.A. area brokers: What is driving plan selection in individual market?

[Jackie Wilson]

Hello! I am a student doing a report on the individual market in the Los Angeles area for a Healthcare Strategy class. I would love to get some thoughts from the broker community on what drives enrollees to different plans these days:

• Is price the most important driver in plan selection? Followed by network?
• Are there provider groups that L.A. residents most like seeing in network? (i.e. strongest name recognition)
• Has the pandemic impacted how your clients choose a plan? (i.e. greater telehealth focus)
• Since L.A. is so diverse, how important are multicultural offerings from plans?

Thanks! Go Bears!

 

[mickeyma]

I have only dealt with Covered California (Obamacare) and Medicare (ages 65+).

--PRICE: For the individual Covered California plan, price is extremely important. Most of these people either have no insurance or are paying a high premium and are shopping to save money.

However, if the agent points out the bad aspects of the lowest cost plan (Bronze which has high deductible of $6.300 and high copayments), most times my clients would accept the "middle" type plan (the Silver Plan with $4,000 deductible in Covered California).

Price is irrelevant in the Medicare market for the 65+ aged since almost all plans are $0 monthly premium.

--PROVIDER GROUPS: Enrollees are not really aware of "provider groups." They only know the names of their doctors and specialists. Once in a while, the specific hospital is important.

--PANDEMIC: No, the pandemic has nothing to do with picking a Medicare plan.
I have not had many sales this past year in the individual market so I guess that the pandemic has had an influence but Covered California reports higher enrollment across the state.

--MULTICURAL OFFERINGS:I have not had any negative feedback on a lack of
muticultural offerings. I only enroll people in plans which accept their Primary Care Physician (PCP = family doctor) and specialist.

However, I do know that Asians, Armenians, Greeks, Turkish and Russian immigrants in Los Angeles want to stay with their existing PCP because of language. Sometimes, that is a challenge to find a plan which has doctor offices where their language is spoken

It's been my experience that price is the most important factor in the individual Covered California market but is not relevant in the Medicare market since the monthly premium is $0 for almost all plans.

Coming in second in Covered California is the high deductible and high copayments. In the Medicare market, the agent picks the plan and presents it to the client. Sometimes, the client will ask about another company because it was referred to them by their family, coworker, neighbor or friend. This is why it is imperative for the agent to be licensed with several carries.

If I can be of any help, don't hesitate to contact me. [email protected]