New Gen Limited/Skinny Group Health

As we continue to endure the uncertainties of ACA repeal/replace efforts in Washington, I thought it might be useful to put forth some drawing board ideas on alternative limited health plans, many of which are lurking behind the scenes at selected carriers who have shared them with me.

What’s holding them back? ACA compliance

As many of you know, my agency specializes in hourly worker plans for service industries like hotel/food/agriculture/nursing homes. These plans emphasize first dollar coverage and eliminate most deductibles and co-insurance. We have found that this approach is more popular among working class employees than traditional major medical.

What’s next? Two ideas are still on the sidelines, but poised to take the concept of Limited Medical Plans to another level, they are:

Direct Primary Care

Imagine the immediate low copayment ($10) access to doctors visits, with no limit on utilization, optional coverage for specific dread disease diagnosis and treatment (Critical Illness coverage) and 24/7 access to doctors by phone. While you are imagining this, also imagine a price point per individual is less than $35 per paycheck!

Middle Medical Plans

This is a concept that began to take hold prior to ACA but was forced to the sidelines as not technically compliant, incorporates many of the more popular cost savings elements of Limited Med with higher inpatient coverage. The primary advantage of this approach is to dramatically reduce premiums by capping the hospital room and board benefits while maintaining popular first dollar primary care. It is estimated that 98% of all claims would fall under these caps

For more information on our services or details on the above options: Call me directly at; 619-301-7460 or

Disclaimer – We do not endorse any of these plans as a takeover of major medical. These plans do not provide for catastrophic coverage and are not intended as a substitute for major medical plans.

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