Thriving in the Bronze Age
How to Profit from the Boom in Supplemental Sales
Peggy Hayes
Vice President, Sales & Business ...
‐ NAHU Newswire, March 14, 2014
Obama Administration
has Tweaked ACA
More than a Dozen Times
Fringe Benefits
1942: tax breaks make health insurance
deductible to the employer and
non-taxable to the employee
 Enrollment lagging
 23% higher
 Costs vary wildly
 Restrictive networks
Exchanges
Platinum Gold Silver Bronze
$6,000 OOP
84% Doctor Visits
subject to Deductible
It’s too risky to take on that exposure if you don’t
have that kind of money.
- Karen Pollitz, Senior Fellow, Kaiser Famil...
Supplemental answers
 Gap
 Indemnity
 Accident
 Critical Illness
Attract and Retain
1) Exchanges
 Individual exchanges
 SHOP exchanges
2) Self-insure
3) Re-define Eligible Pool
 Spouses
 Part-time worke...
6) Minimum Essential Coverage
 “MEC”
 “skinny” plans
 Does not qualify as “Minimum Value”
 Employee avoids the penalty...
“Skinny” plans pass muster
 No annual dollar cap
 No deductibles or copays
 Non-discrimination rules
Supplemental answers
 Gap
 Indemnity
 Accident
 Critical Illness
What are “gap plans”?
 Not indemnity plans
 Never pay more than the actual out-of-pocket
costs incurred
 Built around t...
Gap plans
 Are not designed to cover all gaps
 Have limitations
 Are actuarially different from major medical plans
 M...
Fixed Indemnity
 Pay set amounts, regardless of the cost
 Still available!
The result has been an increase in lean insurance
offerings such as ‘fixed indemnity’ plans.
It’s a plan that we understan...
Accident
 Flexible benefits
 Indemnity vs. “actual charges”
 24-hour or non-occ
 Individual or group
Critical Illness
 Flexible benefit designs
 HSA compatible or not
 Individual or group
 Be an advisor
 Employer-sponsored insurance is here to stay
 94% expect voluntary benefits to increase
- Voluntary Ben...
Thank you!
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
April 2   3 00pm - peggy hayes
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April 2 3 00pm - peggy hayes

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April 2 3 00pm - peggy hayes

  1. 1. Thriving in the Bronze Age How to Profit from the Boom in Supplemental Sales Peggy Hayes Vice President, Sales & Business Development
  2. 2. ‐ NAHU Newswire, March 14, 2014 Obama Administration has Tweaked ACA More than a Dozen Times
  3. 3. Fringe Benefits
  4. 4. 1942: tax breaks make health insurance deductible to the employer and non-taxable to the employee
  5. 5.  Enrollment lagging  23% higher  Costs vary wildly  Restrictive networks
  6. 6. Exchanges Platinum Gold Silver Bronze $6,000 OOP 84% Doctor Visits subject to Deductible
  7. 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. 8. Supplemental answers  Gap  Indemnity  Accident  Critical Illness
  9. 9. Attract and Retain
  10. 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. 11. 6) Minimum Essential Coverage  “MEC”  “skinny” plans  Does not qualify as “Minimum Value”  Employee avoids the penalty  Employer $3000 fine still applies
  12. 12. “Skinny” plans pass muster  No annual dollar cap  No deductibles or copays  Non-discrimination rules
  13. 13. Supplemental answers  Gap  Indemnity  Accident  Critical Illness
  14. 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. 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. 16. Fixed Indemnity  Pay set amounts, regardless of the cost  Still available!
  17. 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. 18. Accident  Flexible benefits  Indemnity vs. “actual charges”  24-hour or non-occ  Individual or group
  19. 19. Critical Illness  Flexible benefit designs  HSA compatible or not  Individual or group
  20. 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. 21. Thank you!
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