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April 2 3 00pm - peggy hayes

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  • 1. Thriving in the Bronze Age How to Profit from the Boom in Supplemental Sales Peggy Hayes Vice President, Sales & Business Development
  • 2. ‐ NAHU Newswire, March 14, 2014 Obama Administration has Tweaked ACA More than a Dozen Times
  • 3. Fringe Benefits
  • 4. 1942: tax breaks make health insurance deductible to the employer and non-taxable to the employee
  • 5.  Enrollment lagging  23% higher  Costs vary wildly  Restrictive networks
  • 6. Exchanges Platinum Gold Silver Bronze $6,000 OOP 84% Doctor Visits subject to Deductible
  • 7. It’s too risky to take on that exposure if you don’t have that kind of money. - Karen Pollitz, Senior Fellow, Kaiser Family Foundation “ ”
  • 8. Supplemental answers  Gap  Indemnity  Accident  Critical Illness
  • 9. Attract and Retain
  • 10. 1) Exchanges  Individual exchanges  SHOP exchanges 2) Self-insure 3) Re-define Eligible Pool  Spouses  Part-time workers 4) Re-define contribution strategy 5) HRAs, HSAs, FSAs
  • 11. 6) Minimum Essential Coverage  “MEC”  “skinny” plans  Does not qualify as “Minimum Value”  Employee avoids the penalty  Employer $3000 fine still applies
  • 12. “Skinny” plans pass muster  No annual dollar cap  No deductibles or copays  Non-discrimination rules
  • 13. Supplemental answers  Gap  Indemnity  Accident  Critical Illness
  • 14. What are “gap plans”?  Not indemnity plans  Never pay more than the actual out-of-pocket costs incurred  Built around the underlying major medical plan
  • 15. Gap plans  Are not designed to cover all gaps  Have limitations  Are actuarially different from major medical plans  May cause stabilization of medical plan rates
  • 16. Fixed Indemnity  Pay set amounts, regardless of the cost  Still available!
  • 17. The result has been an increase in lean insurance offerings such as ‘fixed indemnity’ plans. It’s a plan that we understand, and our employees understand. We believe it’s what a lot of our employees want. - Bare-Bones Health Plans Survive Through Quirk in Law, Wall Street Journal, January 16, 2014 ” ” “ “
  • 18. Accident  Flexible benefits  Indemnity vs. “actual charges”  24-hour or non-occ  Individual or group
  • 19. Critical Illness  Flexible benefit designs  HSA compatible or not  Individual or group
  • 20.  Be an advisor  Employer-sponsored insurance is here to stay  94% expect voluntary benefits to increase - Voluntary Benefits Expected to Grow in 2014, Eastbridge’s Confidence Index Survey, BusinessWire
  • 21. Thank you!