So What's Really Going to Happen to the Group Market

[Crabcake Johnny]

Ok, everything goes as planned. 2014 hits and all state exchanges are operational with subsidies per the PPACA which means subsidies as high as 85% for people between 133% and 250% of FPL. That's a large group of people folks.

So, you're working for ABC company as a low-level worker. Maybe making $35,000 a week - wife and kids.

You have coverage through work, but $60 per week comes out of your check. Add wife and kids? Premium goes through the ceiling.

But wait. Now you can choose an exchange plan and get your entire family covered for less than your group plan. Oh, and you now have your choice of carrier.

Employee talking to another employee at lunch; "What, you're still on our garbage company plan? Man, I just got a plan from the exchange and it's cheaper."

So, especially for lower level workers, does group implode?

Sure, there's a penalty for groups of a certain size to ditch it and send everyone into the exchange. Not what I'm talking about. I'm talking about the employees themselves saying "Finally I can get rid of this junk."

For those not in the know, because you have a "group plan" by doesn't mean you like it. The last group plan I had was working at a car dealership. My wife and I hated it. And every year we all gathered for the same speech; "Ok, we're taking more out of your check and by the way, your deductible is going up - see you next year."

 

[STIBROKER]

For those not in the know, because you have a "group plan" by doesn't mean you like it. The last group plan I had was working at a car dealership. My wife and I hated it.

Everyone hates their Health Insurance....group or individual.......

 

[Crabcake Johnny]

STI, it's exactly what I'm talking about. Even people employees with a good group plan love to grumble. It's why I'm posing the question about whether or not they'll be a mass exodus, especially of rank and file employees, when the exchanges are open for business.

 

[STIBROKER]

STI, it's exactly what I'm talking about. Even people employees with a good group plan love to grumble. It's why I'm posing the question about whether or not they'll be a mass exodus, especially of rank and file employees, when the exchanges are open for business.

but they hate the government even more and most do not trust them with their health insurance......

 

[0b1kanobee]

"Ok, we're taking more out of your check and by the way, your deductible is going up - see you next year."

That just happened at my lady's work this week LOL They put them all together in a hotel banquet room, gave them all a BIG breakfast and told them the good news.

 

[Crabcake Johnny]

You lost me STI. They'd be picking from Blue Cross, Aetna, UHC, Humana, etc...in the exchange. What's the government have to do with it?

 

[STIBROKER]

You lost me STI. They'd be picking from Blue Cross, Aetna, UHC, Humana, etc...in the exchange. What's the government have to do with it?

I think the public will view the exchange as being run by the govt..........

 

[taterpeeler]

This is exactly what I have been predicting and discussing with some clients. The small group market will implode right about the time 01/2014 comes. Why on earth would any company with 25 oe so employees offer group... please someone justify why a compny of 15 would offer group with all the burdens that come with it... all the BS and time consuming nature of selecting, applying and administrating the plan... why I ask... why?
here is how the process would go.... group meeting of workers.... goodmorning folks, we no longer offer insurance because you can get the plan of your choice at a lower cost because all you people will get a subsidy and its your plan not our plan to take with you anywhere you work.... oh, also... all employees are getting a raise of 50 bucks a week...

game over for the small group market..... someone explain why not.... there is no penalty from what i understand for small employers to do this stunt...

so in conclusion... the indy market will EXPLODE with new people and there is no way in gods green earth they will posess the ability to sign up themselves.... it will become a free for all and agents will go wild signing people up. the agent will be required to learn and understand the IRS subsidy guidelines and assist the client in submitting those docs..... lots to learn folks

lets look at the obama high risk plan.... once he figured out no one had the ability to do it on their own he threw agents a 100$ cookie to do it.... MA plans have agents to sign folks up although they also do it in house... if the MA plans had the ability to do it alone they would but the cant... they need agents... period...

here is whats gonna happen and yes im tipping my hand at how i have felt from day one.... agents will get probably 50$ a person... or 100$ a person... or mabye even 435$ an "up" to do it... we will be required to certify just like MA plans and we will go our merry way.......

companies going out of business... lead venders.....agents living on advances or pay check to paycheck...... MGA's and GA's or recruiting guys..... the indy agent with the ability to harvest clients on their own will be the victors in this battle... game on

 

[Crabcake Johnny]

I think the public will view the exchange as being run by the govt..........

No - only if the public option would have gone through. They'll view it as getting coverage through Blue Cross, Aetna, UHC, Humana, etc...

People in MA don't view it as "government health insurance." They simply log into the Connector and choose a carrier.
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This is exactly what I have been predicting and discussing with some clients. The small group market will implode right about the time 01/2014 comes. Why on earth would any company with 25 oe so employees offer group... please someone justify why a compny of 15 would offer group with all the burdens that come with it... all the BS and time consuming nature of selecting, applying and administrating the plan... why I ask... why?
here is how the process would go.... group meeting of workers.... goodmorning folks, we no longer offer insurance because you can get the plan of your choice at a lower cost because all you people will get a subsidy and its your plan not our plan to take with you anywhere you work.... oh, also... all employees are getting a raise of 50 bucks a week...

game over for the small group market..... someone explain why not.... there is no penalty from what i understand for small employers to do this stunt...

so in conclusion... the indy market will EXPLODE with new people and there is no way in gods green earth they will posess the ability to sign up themselves.... it will become a free for all and agents will go wild signing people up. the agent will be required to learn and understand the IRS subsidy guidelines and assist the client in submitting those docs..... lots to learn folks

lets look at the obama high risk plan.... once he figured out no one had the ability to do it on their own he threw agents a 100$ cookie to do it.... MA plans have agents to sign folks up although they also do it in house... if the MA plans had the ability to do it alone they would but the cant... they need agents... period...

here is whats gonna happen and yes im tipping my hand at how i have felt from day one.... agents will get probably 50$ a person... or 100$ a person... or mabye even 435$ an "up" to do it... we will be required to certify just like MA plans and we will go our merry way.......

companies going out of business... lead venders.....agents living on advances or pay check to paycheck...... MGA's and GA's or recruiting guys..... the indy agent with the ability to harvest clients on their own will be the victors in this battle... game on

That's my prediction. With no changes, group implodes (especially small group) and individual explodes.

Also remember the "navigators" who will be cold-calling on small group owners to ditch their group plans and have everyone enroll in the exchange. Wait....that's an insurance violation in most states. Good thing navigators don't need a license.

Plus, any small group owner who actually wanted to continue to mess with this stuff would need to have their head examined. Just as Peeler said "Here's your pay raise, see you later."

 

[leevena]

Taterpeeler is partially correct.

Small group's (say under 25) will more than likely not offer group health plans. Where that number is I do not know, but some smaller groups will continue to offer simply because it is in their best interest. There will not be many, but a few.

I disagree with respect to the individual market and the need for brokers/agents...I just don't see it happening that way. With the significant restrictions on plan design, a very simple enrollment process these types of enrollment will occur via sales portals on-line, without the need for a broker/agent. This process will be no different than the current method for enrolling people into Medicare via the current exchanges.

For the time being I am betting that the larger groups will retain their private programs. Over time the penalties will begin to increase, providing these groups even more financial incentive to stay private.