This seems like an obvious statement, doesn’t it? In fact, it’s almost insulting – the idea that you might not be doing whatever’s necessary to earn your clients’ business every single year. We don’t mean it that way. The truth is that most agents reach out to their clients at renewal time each year, but most of the time no changes are necessary. If your customers are happy with their plan, their family situation and health status hasn’t changed significantly, and the renewal offer is reasonable, most people would rather stay put than to shop around and go through the hassle of changing their health insurance.
Of course, as we all know, these aren’t normal times—far from it. In this, the fourth annual open enrollment period under the health reform law, the majority of our individual clients will require our attention. And you know the reasons why:
As reported by the Washington Post, the Obama administration has confirmed that the average monthly cost for silver-level coverage is going up by an average of 25% this year in the 39 states that use Healthcare.gov. For many individuals not receiving a subsidy, health insurance may be out of reach. At the very least, they’ll need to search for lower-priced options.
In an effort to keep costs under control, and in an attempt to reduce adverse selection, most carriers have moved to narrow-network and even network-only plans. This means that people who renew their existing coverage may no longer be able to see their favorite providers.
This trend, above all, is why you need to reach out to each and every client this year. Major insurance companies like Aetna, Humana, and UnitedHealthcare, along with a number of regional health plans, have made the decision to pull their Marketplace coverage in many areas for 2017. In fact, the same Washington Post article points out that one in five Marketplace consumers will have only one plan option available to them during the open enrollment period.
To elaborate a little on the final point, your clients will need definitely your assistance if they’re losing their coverage, but the government could beat you to it. According to the Associated Press, HHS will “match affected consumers” to carriers that will continue to sell Marketplace coverage. When an individual logs in to Healthcare.gov, an alternate plan will be highlighted for the consumer to consider.
Obviously, this “matching” program could cause some major problems for your clients. To begin with, as the AP article points out, the alternative plan could “look like a ‘recommended choice’ by the marketplace,” and people might go ahead and accept this recommendation without exploring their other options. With all of the recent changes to provider networks and prescription drug formularies, this could be a mistake; as you know, it’s important to compare more than premiums and out-of-pockets. Second, for the 20 percent of Marketplace customers not receiving a subsidy, there may be other options available outside of Healthcare.gov, but the matching program disregards those other options. Third, and perhaps most importantly, the matching program excludes the agent. This is bad for you and it’s bad for your clients. Not only could it cut off your commission payments (assuming the new carrier is still paying commissions), it would also prevent you from servicing the account throughout the year.
Long story short, it’s more important than ever that you reach out to your existing clients during this open enrollment period and make sure they consult with you before making any changes to their coverage.