Re-Branding Limited Medical Plans

There are dynamic forces at work that are changing the world of traditional health insurance. One significant force is the emergence and popularity of *non-traditional group healthinsurance. Originally driven by the Affordable Care Act, these plans are increasingly looked upon as viable alternatives to primary employer sponsored health insurance. The real breakthrough begins with re-branding and re-examining the role of the so called “limited medical plan”

*Access/Incentive plan (no deductibles or coinsurance)

In addition to providing primary ACA compliance, certain limited med plans (coupled with Minimum Essential Coverage) provide (a) no cost access to basic health care for low income employees (b) brokers/agents with tools that increase agency growth, including fresh prospecting ideas and (c) are extremely effective in addressing the growing turnover crisis among low wage (service sector) industries.

Why do we need to re-brand or re-define these plans? I have provided a link for to retrieve a publication or eBook, this book includes many of the lessons learned and developed over the last 20 years. In this book I explain in detail (using example plan designs) just how useful a well designed and marketed limited plan can be. I am convinced these practical strategies can help grow your book, primarily by differentiating your knowledge and skills against your competitor who, by comparison, will look ill-informed and out of touch. We are selling perception of value, this is much harder to do with plans that create financial **barriers to care.

**Disincentives (deductible and coinsurance and higher shared costs)

Re-Branding and Re-Positioning Limited Medical Plans

As mentioned above, in our eBook, we explain why we have re-branded limited medical and major medical to reflect how they actually finance the delivery of healthcare. Limited Meds are identified as *Access/Incentive Based Plans, while traditional MMs we are called **Disincentive Based Plans. Below are examples of some of our eBook strategies.

*Access/Incentive (no deductibles or coinsurance, lower cost) **Disincentives (deductible and coinsurance and higher payroll deduction costs)

Example 1 – Over (ACA) Compliance

We point out that there is no need to over insure workers (providing minimum value plans and over priced MEC only) simply to comply with ACA. This over insurance tends to expose the employer to more cost and risk, while solving a problem that has very little effect on employers (the “B” penalty for Minimum Value) more importantly, it exposes the current broker’s lack of understanding of the marketplace and creates opportunity for you to compete for his/her client.

Example 2 – Turnover Reduction

By using increasingly richer plans, indexed to length of services, you can reward employee retention and greatly reduce turnover. The fact is, the cost of turnover far exceeds the cost of increased benefits.

Example 3 – Lower Cost Alternative to Major Medical

Actively promoting Access Based plans as a viable alternative to major medical for low wage and even some moderate wage workers is a winning strategy. I believe that a high-level Access Plan ($150,000 limits) with some form of Critical Illness more than adequately protects those employees now covered by traditional (major med) insurance and does so at a much lower cost. Added to this is the fact that employees who are not being offered Major Medical can freely enroll in an exchange plan, assuring catastrophic coverage for themselves and thier family.

I realize some of what I am proposing is controversial and many of you will disagree with my implication that Access Based plans are inherently more favorably viewed by employees. I feel comfortable that these plans better serve the working class employee by providing less financial constraint on utilization, therefore viewed by these employees, as providing a more valuable employee benefit than traditional plans with disincentives to restrict utilization.

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