Sterling Option 1 PFFS

wilkin · 07-10-2007, 12:22 PM

I just lost a Med Supp prospect to the Sterling Option 1 PFFS plan. Here in PA it is $9 bucks a month and after reviewing their benefits at their website, I am impressed. I am not a fan of these plans but do sell them when necessary; have sold maybe a dozen Coventry Advantra Freedoms and a couple Todays Options.

Sterling was one of the first PFFS plans to surface in our area 3 years ago and I never ran into many people talking about giving them consideration. The BIG ones here are BC and BS. They have TONS of advertising money and flood the market via TV, Radio, newspaper, etc.

Is anybody familiar with Sterling? Are they a force in your areas?

-Bill

*midwestbroker* · 07-10-2007, 12:25 PM

You shouldn't be loosing any more sales to them since they are on a enrollment freeze.

We have them here in KC. They are only in 1 or 2 counties. Decent benefits but not a major player.

senior-advisor-indiana · 07-10-2007, 12:49 PM

They shouldn't be on freeze from enrollment. If you are talking about the voluntary hault then they can still sign up directly through the comany. Just can't have an agent in the process. I don't recall seeing sterling as one of them that voluntarily ceased though?

Cenla Agent · 07-10-2007, 02:09 PM

Originally Posted by senior-advisor-indiana

They shouldn't be on freeze from enrollment. If you are talking about the voluntary hault then they can still sign up directly through the comany. Just can't have an agent in the process. I don't recall seeing sterling as one of them that voluntarily ceased though?

I don't remember them being included in the group that voluntarily ceased either. One thing to watch on their plan (and others) is whether it has a maximum out of pocket limit. In LA (where it is also $9) it does not. Another thing to watch for on some of the PFFS plans is benefits that will have them paying more out of pocket than they would with A&B only. SNF is like that on almost every plan, but others that jump out are requiring copays for Medicare covered home health, 50% or more coinsurance for DME, etc.

*midwestbroker* · 07-10-2007, 02:49 PM

Sterling was part of the hold on PFFS plans.

A person can enroll via online or on the phone, but the % that do that is very small, compared to agent sales.

I just pulled their SOB and they seem to have a lot of 90/10 splits. The 50% DME is if you do not get an auth from Sterling for items over $750.

sman · 07-10-2007, 04:49 PM

Originally Posted by Cenla Agent

I don't remember them being included in the group that voluntarily ceased either. One thing to watch on their plan (and others) is whether it has a maximum out of pocket limit. In LA (where it is also $9) it does not. Another thing to watch for on some of the PFFS plans is benefits that will have them paying more out of pocket than they would with A&B only. SNF is like that on almost every plan, but others that jump out are requiring copays for Medicare covered home health, 50% or more coinsurance for DME, etc.

Yep. The 7 carriers are United Healthcare, Humana, Wellcare, Universal American (Pyramid), Coventry, Sterling and BCBS of Tennessee.

Here's a link:

http://www.cms.hhs.gov/apps/media/pr...boOrd er=date

Cenla Agent · 07-10-2007, 04:55 PM

Originally Posted by sman

Yep. The 7 carriers are United Healthcare, Humana, Wellcare, Universal American (Pyramid), Coventry, Sterling and BCBS of Tennessee.

Here's a link:

http://www.cms.hhs.gov/apps/media/pr...boOrd er=date

Off the top of my head those are the major nationwide players with PFFS.