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Expanded Short Term Plans

By now you’ve probably heard the news: the Department of Health and Human Services, in conjunction with the Department of Labor and Department of Treasury, has issued the final rule on the expansion of short-term, limited duration health insurance plans that the President called for in his executive order last October. The rule expands the length of short-term plans, which is a big deal for healthy individuals who do not have access to employer-sponsored coverage and who do not qualify for a premium tax credit.

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Can Employers Pay Their Employees’ Medicare Premiums?

It’s a good question. Because of the Affordable Care Act (ACA), age is a huge rating factor for small-business employers, with health insurance carriers charging up to three times as much for older workers as they do for younger employees. While larger and self-insured companies are not subject to the ACA’s modified adjusted community rating rules, age is a big rating factor for them as well.

So what’s the answer? Can an employer pay for Medicare Part B and D, Medicare Advantage, and/or Medicare Supplement Insurance premiums for their employees, and either require or encourage them to drop off the group health plan? If so, it might be a good strategy for companies who have seen their premiums skyrocket in recent years, and it could be a great way for brokers to save their clients some money.

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Changing from Marketplace to Medicare Coverage

If you’ve been selling Marketplace plans for the past five years, then you probably have a number of clients who are currently receiving premium tax credits. As these clients approach age 65, it’s important to let them know that they will no longer be able to receive a premium tax credit when they sign up for Medicare. Both Healthcare.gov and Medicare.gov have pages devoted to educating consumers about this topic, but it’s unlikely that your clients will read this information unless you point it out to them.

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We’re getting more and more questions from agents asking what they can sell right now. We know that the fourth quarter is the busy time of the year, but the other nine months can leave brokers twiddling their thumbs.

As we’ve mentioned in previous posts, the “slow time” of the year provides a great opportunity to make plans for the next selling season. You can learn about new solutions that could be a good fit for your clients; line up prospects and pre-schedule appointments; and implement processes that will help make you more efficient.

Of course, you can only do so much planning, and it would be costly and irresponsible not to use the nine months between open enrollment periods to make some additional sales.

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The Association Plan Final Rules Explained

Back in October, President Trump issued an executive order that, among other things, asked the Department of Labor to re-write the rules for Association Health Plans. On January 4, the DOL honored that request and issued proposed rules. After a comment period, those rules were finalized on June 19. Because the final rules are 198 pages long, we figured we’d save you some time and give you the high points.

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Compared with 2018, the minimum deductible was unchanged for those with single and family coverage; the maximum out-of-pocket increased by $100 for people with self-only coverage and $200 for those with family coverage; and the contribution limit increased by $50 for self-only plans and $100 for family plans.

The catch-up contribution for those over the age of 55 remains $1,000 per year and must be deposited into an account in the individual’s name. That means that married couples age 55 and older must set up separate accounts if they both want to take advantage of the catch-up contribution.

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Want to Stand Out? Do Something Different.

Salespeople who want to edge out their competition need some sort of hook, something they do differently than everyone else. In health insurance, that can be difficult to do since agents neither design nor price the products that they sell; the plans are the plans and the rates are the rates.

What that means, of course, is that we have to find something else to differentiate ourselves. In this post, we share a few ideas to help you do that. Our recommendations fall into three categories: 1) what you sell, 2) when you sell it, and 3) how you sell it.

One quick point before we begin: the more you can surprise people, the more unexpected your differentiation strategy, the more likely it is to get a prospect’s attention and make a lasting impact.

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How much do doctor visits cost?

If you’re a fan of Health Savings Accounts, you’ve probably experienced the frustration of trying to explain to clients why a High Deductible Health Plan with no up-front copayments is a MUCH better deal than a traditional plan with copayments for doctor visits and prescriptions, only to have the client ignore your advice and select the more costly plan that will not allow them to pay with tax-free dollars.

Why do people make decisions that aren’t in their best interest? Why do they insist on overpaying for their health insurance? Why are they willing to accept a higher deductible and higher out-of-pocket max just so they can go to the doctor for a predictable, flat-dollar fee?

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Insurance: Rocket Science or Basic Math?

As you know all too well, most people find health insurance confusing. Very confusing. Otherwise intelligent people seem completely baffled by deductibles, copayments, and coinsurance, and they frequently use the terms interchangeably.  There have been surveys that find people would rather have a root canal than shop for health insurance—to them, it would be less painful.

This, of course, presents a challenge for brokers who need their clients to understand their options so they can select the plan that is best for themselves and their families.

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Making Sense of the New ACA Lawsuit

You may have seen the news that the Department of Justice is no longer defending the Affordable Care Act against a challenge that, now that the penalty is being eliminated, the individual mandate is unconstitutional including certain protections for people with pre-existing conditions. We wanted to provide a quick explanation of what’s going on to help you better explain the developments to your clients.

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