Insurance Agent Forum

[healthagent]

When properly presented a majority of your sales will be HSAs. It's a windfall for your client and you as the agent.

I always quote the HSA first "Ok sir, your premium for your family is $350 a month. Let me explain how it works."

If I hit a snag when explaining no copays I just say: "Oh, you want copays? That's not a problem. Let me get that rate......ok.......it's $580."

Now you have a HSA sale.

[somarco]

I show 1 copay plan along side 3 - 4 plans without copays (not all HSA's) with minimal details, but all have about the same OOP on a major claim. They always ask why one plan is so much more than the others.

I am so glad you asked . . .

[arnguy]

Thanks for the feedback in individual HSA's guys. I am waiting to hear from STI since I think he does not have a high opinion of HSA's.

Also, the gist of the9/25/06 WSJ article (and the Inquirer article) was that GROUP HSA's place a burden on the employer , particularly the Human Resources personnel, with regard to researching medical procedure costs and Rx costs. Anyone have experience with Group HSA's?

[James]

Originally Posted by arnguy

Thanks for the feedback in individual HSA's guys. I am waiting to hear from STI since I think he does not have a high opinion of HSA's.

Also, the gist of the9/25/06 WSJ article (and the Inquirer article) was that GROUP HSA's place a burden on the employer , particularly the Human Resources personnel, with regard to researching medical procedure costs and Rx costs. Anyone have experience with Group HSA's?

This is a problem that is epidemic within the health care industry. If congress had anything useful too add in the matter of health care it would be to create a national standard and force the health care industry to have full disclosure. Something to my knowledge has never been done in any useful way.

[James]

Originally Posted by arnguy

Thanks for the feedback in individual HSA's guys. I am waiting to hear from STI since I think he does not have a high opinion of HSA's.

Also, the gist of the9/25/06 WSJ article (and the Inquirer article) was that GROUP HSA's place a burden on the employer , particularly the Human Resources personnel, with regard to researching medical procedure costs and Rx costs. Anyone have experience with Group HSA's?

If I remember correctly Sti attempted to attack the actual HSA Vs other saving vehicles or the absense of savings (credit cards) not with the actual HD Plan. Yet I think he was squarely defeated in his reasoning if I remember correctly and it sounded more like a "Devils Advocate" type of debate more so then anything else. Yet if you are seeking out negativity then why not be honest with yourself and just not sell HSA's? Its really hard to sell anything if you seek out the negative comments. Reminds me of the media making a negative story out of our soldiers getting such great medical treatment in the field of battle in Iraq, lets face it, if you seek out negativity you'll find it in anything.

[somarco]

My exposure to group HSA's has been limited both in number of groups & size of the group. So my comments may not weigh in as much.

Small groups, large groups, doesn't matter. When introduced there is much grumbling by the employees. There is a reluctance to accept the plan, especially if there are other choices. Those that have the plan love it until they run out of the employer contribution to the HSA then they hate the fact they have to pay full price rather than a $10 copay.

My opinion is . . . pisssss on them.

Haven't heard any complaints about the admin portion but that is not to say there aren't issues there.

[arnguy]

James, I am not being negative about HSA's----I have not delved into that market and I am neutral at this point in time. I am just trying to elicit information and opinions from all sides. I do appreciate the the comments.

[midwestbroker]

The people that really have an understanding of healthcare in America look into HSA plans. There are plans that cost the same or less then regular major medical plans but can cut the max out of pocket in 1/2 and provide 100% co-insurance.

The others who want unlimited $10 co-pays still have their head in the sand, and prob will until they ever leave their job. They are the ones who want everyone else to take care of them because they spend more planning a vacation then planning their life.

Originally Posted by john_petrowski

Let's do a HSA vs Copay plan for a family of four in my zip code - male 45, female 45 and two kids zip code 21128. I'll match the individual liability for apples to apples comparison.

Say the husband has HBP with drug cost of $85 per month
Wife has high cholesterol for $65 per month

Assurant Max Plan:
$2,500 deductible
$3,000 OOP 80/20
$35 copay
$15 generic/$25 name brand + 20% with $500 deductible
Individual OOP = $5,500
Family OOP = $11,000
Premium = $689

Assurant HSA
$5,400 deductible
100% coinsurance
No copays for doc visitis or drugs
Individual OOP = $5,400
Family OOP = $5,400
Premium = $431

Ok, the individual liability is the same but the family liabilty is cut in half for the HSA. Right there the HSA wins hands down.

The savings is $3,096 per year. For the HSA to be a bad deal they'd have to be use $3,000 worth of doctor visits and drugs.

First of all, they get all doctor visits at the network rate. Let's say it's $60 to see a doctor. On the copay plan it would have been $35 so the difference is $25. So the client is spending about $25 more on doctor visits. Saving $3,000 a year that's 120 doctor visits. Doubtful they're going to the doctor 120 times a year.

Drugs. Again, they'd have to be on $3,000 a year of medications. Ummmm, if they were they'd never get through underwriting so that's a non-issue.

So the HSA always wins. Always. Plus you get the tax savings on the HSA. AND for the finale - once you hit the OOP on the HSA everything is free - all drugs and doctor visits. No true on the PPO where you always have copays for doc visits and drugs.

Please realize articles are written by the liberal press and they want free healthcare for everyone.

John, what "load" did you use to get these quotes? I'm getting different numbers and the CoreMed beat them both.

[healthagent]

The CoreMed is cheaper than the Max plan for obvious reasons. But CoreMed is cheaper than a HSA because it has twice the family liability, no wellness for a year, 50% coinsurance on drugs and no mental/nervous disorder benefit on top of a $750 per day times three days access fee for inpatient and $200 for outpatient.

Just based solely on price and nothing else the client could perceive more value with the CoreMed if they're on a small amount of meds and see a doctor a few times a year. They get the $35 copay and possibly $15 flat for generic meds.

But if a large event occurs they would wish they'd have chosen the HSA.

In the end you cannot push anything on a client. You want a lapse? Shove a HSA down someone's throat who either doesn't want it or doesn't understand it.

All you can do as an agent is educate and explain. That's it. After that the client chooses.

I have a client now who I sold a Value Plan to just about two years ago. She's now diagonsed with a condition and and the total cost of her two meds per month are just over $300. Guess what - she owes $150 of it because of the 50% drug coinsurance. The call was that she can't afford it. She also has a $3,000 deductible plus $2,000 of coinsurance she has to pay because she just had a procedure.

She could have chosen the HSA with $2,600 of total liability. Almost the exact same rate but she'd be on the hook for only $2,600 instead of $5,000 and ZERO cost for her meds. Now she's screwed. She can't cancel her plan, she's not eligible for the state plan and she can't afford the $5,000 bill or the extra $150 for her meds. It was not a happy conversation. I also recommended a HSA for her and she said no.

[Golddoor]

John,

If there is only one person on the policy then what do you do for an HSA plan with Assurant? Would you still go with the one deductible? Or the Saveright?

[insurebob]

The person who invented the One Deductible for Assurant should get a raise, the corner office, and Pam Anderson as his personal secretary. Unless you are on several meds, One Deductible, with or without the HSA is the best that's out there.

I always sell the 100% plan. Makes it nice and simple. That's the way the people like their health insurance.

As far as HSA with groups, it's on an individual basis. Employees will always gripe about the loss of the $30 copay. As they say in Russia, toughky shitzky.

Since I only work with small employers, I cannot speak on behalf of mid to large size companies. I've noticed a 50/50 split. If there are health issues with one of their employees (several HBP meds, etc.), then they prefer the copay. If it's a healthy group, most go with HSA's, and fully understand that they are going to pay the negotiated rate, and not a flat rate. Their okay with it.

Just because HSA's are new, and touted by the President, and our very own Clark Howard, that doesn't mean they are for every one or every business.

But, when you talk HSA (individual/family) plans; for me, it's Assurant's One Deductible - all day long.

[healthagent]

Copays foster abuse which leads to higher rates for everyone. I personally know people who live at the doctor's office. They go for every ache and pain. They'll take their kids for a 100 fever when they should have gone to Rite Aid.

You know darned well when you need medical attention. The HSA makes you think "do I REALLY need to see a doctor today?"

I'm a fan of wellness checks to catch anything early but aside from that medical care in this country is horribly abused. I was in a doctor's office last week with one of my reps to help him deliver quotes. There must have been at least 30 people in the waiting room. My guess would be 26 of them didn't need to be there.

Most likely these are people on company "$10 copays" plans looking for time off work or for $10 they can afford to be hypocontriacts. Put them on a HSA and watch that waiting room clear out.

When I go to sell a HSA I'll say things like:

"Ok, so you only saw the doctor twice last year. That's great - you clearly don't abuse the system. I'm assuming you don't want to pay for people who do."

I just got tires on my car - paid over $500 total. Shouldn't car insurance pay for that?

[somarco]

I just got tires on my car - paid over $500 total. Shouldn't car insurance pay for that

?

Uh-huh . . . after the deductible . . .

[Melmunch3]

I have a bunch of groups with HRA and HSA plans and I have seen two types. Those with well educated employees, that rarely bother us, and those that needed more help in the beginning. However, after a few months, everyone is happy. We offer individual consultations to show exactly how each employee will be better off with the new plan. We often secure a commitment from the company that they will designate 10% of the savings to take care of any employees that are negatively effected. (We build it in to the price and then explain the earmark)

That article seemed silly to me. They may bug the HR director for the first few months, but they will save money in perpetuity. From a long term perspective, it is a well wothwhile investment.

Additionally, after you are a year or two into the plan, and people have carryover dollars, they really love it.

[wildcat]

Is anyone offering the Lumenos plans? Wellpoint is opening them up, I believe, in all of their states. Traditional HSA plans with a twist. There is unlimited coverage for all preventive care visits. Annual physicals, pap & mammograms, immunizations etc.

[CT Insure Guy]

I think HSA are the greatest invention since the rear wheel drive German sports car...or Beer Hats!

Seriously though, if everyone purchased this type of coverage, only insuring against the things that could have severe financial impact, think about how much rates for care would come down in the long run. More people buying into the pool plus no insane amount of nuisance claims to pay for administration on. Then you factor in the lower premium AND tax savings, it's a total win/win.

I love the Assurant One Deductible HSA plan, sell a good deal of that. However, for folks over 50 in good health with very limited budgets(or anyone with very low caps on what they can afford) I don't think the Right Start HSA