Become the Agents of
Change
Pay a Bill
Redefine Your Business and
Thrive in the Age of
Healthcare Reform
Medical Carrier
Be Afraid….. Be VERY Afraid
They're coming for your
commissions!
Don’t Be Frightened by Obamacare.
Protect and increase yo...
Small Businesses 
Dropping Coverage
Seasonal/
Temporary 
Workers
Retirees
Spouses
Unions
Contractors and 
Consultants
Indi...
Source: 2013: Health Partners America. 
Leading Experts – Game
Changer
Source: 2013: Health Partners America. 
Leading Experts – Game Changer
Source: 2013: Health Partners America. 
Leading Experts – Game Changer
Exchanges May Draw 37 Million Already‐Covered Workers
Millions of workers who are covered at work could instead choose ins...
Source: 2013: Health Partners America. 
Leading Experts – Game Changer
Source: 2013: Health Partners America. 
Leading Experts – Game Changer
Payroll Deduction
Premium Persistency
55% of employees feel that payroll deductions for voluntary benefits help them to be...
“Every check a policyholder/customer has to
write provides him or her another opportunity to
reconsider the purchase decis...
The Shift……..
 What We Know:
• The Affordable Care Act (ACA) is here to stay
• Employers are becoming more aware of the p...
The Future?
 Overall, 30 percent of employers will definitely or probably stop offering
ESI in the years after 2014.
 Am...
The Shift……cont.
 What We Know Continued…….
• Employers and employees may no longer pre‐tax individual policies on 
the p...
Follow The Money
The Subsidy Calculator
The ACA Calculator
Illustrative Sample of a 60-
Life Group Commission
Opportunity
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$...
Money the 
government 
contributes to 
the employee 
instead of the 
employer
Total the 
employee pays 
for SILVER (not 
B...
You’ve taken the Plunge – Now What??
 Either your client asks you to enroll their employees on
the exchange
Or
 You proa...
Now oh god you actually have to
sell the individuals and enroll it!!
HOWDOYOUDOTHIS?
What Do You Have
To
Make Decisions
About?
1. Pick the Products
What other products other than the individual medical
Criti...
What Do You Have To
Actually Do
To Enroll The Case?
What About The Money?
Howareemployees
goingtopay?
New Solutions for Carriers,
Brokers, Enrollment Companies
Payment system solutions and banking platform that:
 Bills, col...
Current Employer Challenges
New Payment Solutions
Current Challenges / Headaches
Peace of Mind Solution with Premium
Payme...
Employer Access Strategy in the New World?
As Employees Turn Consumer
without Payroll Deduction Plans…
 Fact – Traditiona...
Keys To Success
 Follow the Money
 Engage Voluntary to enroll your new individuals
 Find new prospects and replace thei...
April 3   9 30am - scott mardis
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April 3 9 30am - scott mardis

  1. 1. Become the Agents of Change Pay a Bill Redefine Your Business and Thrive in the Age of Healthcare Reform Medical Carrier
  2. 2. Be Afraid….. Be VERY Afraid They're coming for your commissions! Don’t Be Frightened by Obamacare. Protect and increase your commissions with new payment strategies that empower individuals
  3. 3. Small Businesses  Dropping Coverage Seasonal/ Temporary  Workers Retirees Spouses Unions Contractors and  Consultants Individuals Indv. Declining Group  Coverage Part‐Timers COBRA Municipalities  and Government  Agencies
  4. 4. Source: 2013: Health Partners America.  Leading Experts – Game Changer
  5. 5. Source: 2013: Health Partners America.  Leading Experts – Game Changer
  6. 6. Source: 2013: Health Partners America.  Leading Experts – Game Changer
  7. 7. Exchanges May Draw 37 Million Already‐Covered Workers Millions of workers who are covered at work could instead choose insurance through state exchanges. How many millions? Roughly 37 million, according to Dr. Jay Bhattacharya of Stanford School of Medicine. “The reason is that these workers would qualify for substantial subsidies to buy exchange insurance,” In other words, the subsidized Obamacare premium will be less than what they pay for employer based insurance. Leading Experts – Game Changer
  8. 8. Source: 2013: Health Partners America.  Leading Experts – Game Changer
  9. 9. Source: 2013: Health Partners America.  Leading Experts – Game Changer
  10. 10. Payroll Deduction Premium Persistency 55% of employees feel that payroll deductions for voluntary benefits help them to be more disciplined about saving. This discipline – coupled with the financial safety net the benefits provide, and an integrated education campaign – can translate into increased enrollment. MetLife Survey – 2013 Payroll deduction participation ranges between 25% and 45% for most products but on direct pay, the rates tend to be in the single digits. Eastbridge Consulting Group – June 2013 The Average American bounces 12.7 checks a year and which generates $9.4 billion in bank fees Compilation American Banker 2012 The Average Pa. checking account balance is $3,100. This would be depleted in less than one year. The Average savings account in Pa. is ONLY $6,100. Pitney Bowes 2012 Payroll Deduction Persistency Drives Participation
  11. 11. “Every check a policyholder/customer has to write provides him or her another opportunity to reconsider the purchase decision.” Joint Study Sponsored by LIMRA International and Society of Actuaries
  12. 12. The Shift……..  What We Know: • The Affordable Care Act (ACA) is here to stay • Employers are becoming more aware of the potential subsidies • Employers are asking their brokers for help transitioning their employees to  the exchange • Brokers are concerned about lower commissions (rightfully so) and their ability  to enroll and engage individuals • Brokers need to be able to drive new revenue from new business and from  existing cases
  13. 13. The Future?  Overall, 30 percent of employers will definitely or probably stop offering ESI in the years after 2014.  Among employers with a high awareness of reform, this proportion increases to more than 50 percent, and upward of 60 percent will pursue some alternative to traditional ESI.  At least 30 percent of employers would gain economically from dropping coverage even if they completely compensated employees for the change through other benefit offerings or higher salaries.  Contrary to what many employers assume, more than 85 percent of employees would remain at their jobs even if their employer stopped offering ESI, although about 60 percent would expect increased compensation. McKinsey and Company – Private sector employer study
  14. 14. The Shift……cont.  What We Know Continued……. • Employers and employees may no longer pre‐tax individual policies on  the public exchange (No HRA’s or PRA’s) • Once employers send employees to the exchange, they may wash their  hands of all administration – no more billing and administration which  limits revenue (VB) opportunities • Medical Insurance is becoming a “voluntary” program
  15. 15. Follow The Money The Subsidy Calculator The ACA Calculator
  16. 16. Illustrative Sample of a 60- Life Group Commission Opportunity $0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $18,450 $4,613 $30,245 Broker Income Outlook under Obamacare Group Broker Commissions Current Group Client Group Broker Commissions as Employees Peel Off Broker Commissions Indiviudal Process Existing Client or Another Group's Broker Account You Take Over Income drops to this lower point as you lose commissions because employees leave the group. Your income when you convert the group to individual coverages and you remain as the broker. You can also sell additional voluntary products
  17. 17. Money the  government  contributes to  the employee  instead of the  employer Total the  employee pays  for SILVER (not  Bronze) Family  Coverage – $172/month By the way, the  Bronze Plan  would be FREE  for this family!
  18. 18. You’ve taken the Plunge – Now What??  Either your client asks you to enroll their employees on the exchange Or  You proactively approached your client with these financial solutions and sold them on your strategy Congratulations!
  19. 19. Now oh god you actually have to sell the individuals and enroll it!! HOWDOYOUDOTHIS?
  20. 20. What Do You Have To Make Decisions About? 1. Pick the Products What other products other than the individual medical Critical Illness, Gap, Life, Pet, Dental, Telemedicine, ID Theft, Disability, Vision, name your product 2. CHOOSE THE CARRIERS? How do you pick between them? Medical, Voluntary/Worksite, Ancillary, etc. 3. How you are going to enroll, administer, and get paid?
  21. 21. What Do You Have To Actually Do To Enroll The Case?
  22. 22. What About The Money? Howareemployees goingtopay?
  23. 23. New Solutions for Carriers, Brokers, Enrollment Companies Payment system solutions and banking platform that:  Bills, collects, and remits payments from individuals directly to carriers  Provides Direct Access to sell employees even when an employer doesn’t offer, sponsor, or assist in providing supplemental benefits This is not the current payroll deduction process or any existing bill consolidation approach! Financial Wellness Strategies
  24. 24. Current Employer Challenges New Payment Solutions Current Challenges / Headaches Peace of Mind Solution with Premium Payment Aggregator Solutions Premium reconciliation, escrow balance recordkeeping and balance sheet headaches No More Reconciliations E.R.I.S.A. Plan Liabilities Same benefits transforms ERISA plans to non- ERISA plans NO ERISA LIABILITY! Lose productivity because one third of my employees are dealing with financial issues Provides employees with budgeting tools and visibility to manage their payments and finances Administrative tasks with helping employees with 401(k) hardship loans – currently 40% of employees request loan withdraws This can be reduced when employees budget their money correctly. HIPAA – Privacy Laws YOU KNOW WHAT EMPLOYEES PURCHASE – SHOULD YOU? Similar to PayPal™, their purchases can be shielded from the employer.
  25. 25. Employer Access Strategy in the New World? As Employees Turn Consumer without Payroll Deduction Plans…  Fact – Traditional group insurance and ESI are on the decline  Question – How are you going to deal with this?  Answer – Provide group-like coverage to individuals o Engage Voluntary! o Maintain the same access o Maintain the same retention when they don’t have payroll deduction  How? Engage a Premium Payment Aggregator (PPA) o Exchange Payment Methods o Voluntary Marketplace Place payment methods
  26. 26. Keys To Success  Follow the Money  Engage Voluntary to enroll your new individuals  Find new prospects and replace their broker  Sell More to Existing Cases  Help make practical the transition from group to individual  Help maintain renewals of the individual product sales
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