which carriers offer the best re-pricing?
It has nothing to do with the carrier. It is all about the network.
As a general rule, BX usually demands (and get's) the deepest discounts but that does not mean they have the best overall value.
HMO's are not far behind in securing discounts.
What is the difference between tier 1 and tier 2 carrier?
Most tier 1 carriers own their network while tier 2 rent them. Less control when you rent, usually can't get the discounts you need.
Rented networks usually have an advantage if you are marketing in the hinterlands.
are tier 1 carrier rates less subject to jump significantly in the upward direction from year to year compared to tier 2 carriers?
Not really.
Tier 1 carriers can do stupid things just like smaller carriers. The tier 2 carriers usually don't last long when their sins catch up with them.
If you try and play the repricing game you will lose.
You will also lose your client either by boring them or getting into a "how much does this cost" game.
You have to break it down into simple steps, then let them decide.
Take this as an example.
Most folks think they want a copay plan and some will even agree to a $2000 deductible in order to keep the premium affordable.
In this case, Aetna has the best value on a $2k copay plan at $484 per month.
I ask clients to focus on the big claim, the one where the truck runs over you, and ignore the little stuff for now.
When the truck runs over you in that Aetna copay plan you have $4k OOP + copays.
Now it becomes simple by asking this. Would you rather limit your OOP to $3000 and save $56 per month or take on a little extra risk by going to $5000 and save $162 per month.
Most folks can't imagine ever having a large claim so the $5k deductible is an easier sale especially when they pocket $162 x 12 or $1944 per year.
When they ask how much it costs to go to a doc I tell them a ballpark is the deductible +$20.
If they really want to get picky I will play the what if game to a point.
If they take meds it becomes easier because I can get a good price estimate on Rx that makes it simple. It also opens the door to talking about lower cost brand Rx and generics as an easy way to sell.
When you factor in loads for meds the sale becomes easier.
Say they take 2 ratable meds. That means a 50% rate up with Aetna (and most other carriers as well).
The copay premium jumps to $556 while the
HSA $5000 increases to $372 for a differential of $184 x 12 = $2208.
Getting them to focus on the premium savings is the key. Every dollar they save in premiums is one less dollar going to the carrier. Once they realize they are funding their own reimbursement under a copay plan vs. the
HSA it usually becomes easy.
HSA Plan Question
Linear Mode
