Moving to Group Sales

timsip

Guru
1000 Post Club
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I have been in the senior health market and through that, I accidentally got into the individual market. After getting that going, I found that market to be a lot of fun. Through my wife, I have been introduced to a person that is looking for group coverage. Problem is that I don't know if I can get her coverage, and if so, what I need to do. Her group isn't an employer group, but a group that online college professors (independent contractors) can join to get access to resources she makes available. She has come to me to help her group get coverage. The good news? She has about 6000 people in her group. The bad news? They are in all 50 states. Through my research, I have found that there are national plans with Aetna. I don't know if there are other carriers that I should explore, if so, please advise. Also, with these national plans, do I have to be licensed in all 50 states, or just the state the group is based in? Finally, is this group considered a group when talking insurance?
 
This group would be considered an association plan.

Very few companies want these types of plans. There is no claims experience.

I chased an association plan with stand up comics. It turned out to be a complete wast of time.

If I were you I would get licensed in all the states and try to sell individual policies to everyone. Then find a broker that has had success with setting up an association and talk to them.

 
Let me explain why association plans don't qualify as "group plans".

The reason a person would buy insurance through an association like this is because they can't qualify to purchase it on their own, so they think they will have better buying power through a "group". Unfortunately, the insurance company doesn't look at it as a group, but as a set of individual plans. A group would have internal controls to make it a group pool - such as a requirement that at least 75% of all eligible employees would enroll in the plan whether they are healthy or not, and the requirement that the employer contributes to the cost, which motivates more employees to enroll in the group plan. No such internal control exists with an association plan. Therefore, it's a set-up for adverse selection, and a target for high claims, resulting in unsustainable price increases.
 
Surely you jest.

(Sorry, could not refuse . . .).


LOL, I know! I was insuring a couple comedy clubs and the owners had set up an Stand up Comic Association. The association was getting discounted rates for anything associated being on the road. They had about 500+ members.

I ended up working with a good limited benefit carrier (if there is such a thing) to set up a plan. It was still going to cost the comics $150 a month and they said that was too much. At that point I walked away.
 
LOL, I know! I was insuring a couple comedy clubs and the owners had set up an Stand up Comic Association. The association was getting discounted rates for anything associated being on the road. They had about 500+ members.

I ended up working with a good limited benefit carrier (if there is such a thing) to set up a plan. It was still going to cost the comics $150 a month and they said that was too much. At that point I walked away.

Oh, well, they don't need health insurance anyway. Laughter is the best medicine!
 
If any and I mean any carrier will look at this it is UHC. You'll have to figure out how many employees are in each state, where the home state is, etc. Enrollment could take months. You might want to look into a mini med plan. Even at that...Enrollment could take months.
 
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