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It’s Selling Season! Here are a Few Reminders.

As you can probably tell, we’re pretty excited here at America’s Health Care Plan. We’re entering the fourth quarter, and very soon the busy time of the year in the Individual, Medicare, and Group Health markets will be upon us. It’s a time of great opportunity, especially this year, so we wanted to offer a few pointers to help you maximize your time and, therefore, your selling potential. We hope you can find a nugget or two in our words that will help your business.

Are you selling dental? You should be.

In the weeks ahead, you’ll be visiting in person or by phone with almost every one of your clients and prospects. That means that you have a great opportunity, with a slight adjustment to your normal sales pitch, to increase your income substantially while offering a great benefit that both individuals and employers will be interested in.

We’re talking, of course, about dental insurance. Do you make a habit of showing it during your sales presentations? If not, now would be a great time to start.

Medicare 101

In just a few weeks, the Annual Election Period for Medicare Advantage and Medicare Part D plans will open, and when it does agents who had intended to start selling Medicare products this year, perhaps because of the instability in the individual market, but who failed to get certified to sell those products will have missed their opportunity. Sure, they can still sell supplements all year long, but the big opportunity that comes only once a year will be behind us and they’ll have to wait until October, 2018 for their next chance.

To help those of you who are still deciding whether to expand your portfolio to include Medicare-related products or not, we thought we’d provide a short “Medicare 101” tutorial. And for those of you who already sell Medigap policies, Medicare Advantage plans, and Medicare Part D prescription drug plans, this should serve as a nice refresher. Since it’s often necessary to educate clients and prospects about what they currently have before explaining what their options are, knowing how to do that in concise terms may prove helpful. Here we go…

What’s Your Job Description? Is It Changing?

When a company is searching for a new employee, it often provides a “job description” that explains the qualifications for the position in terms of experience and education, highlights the big areas of responsibility the job would entail, and details the various tasks the employee would be expected to perform on a daily basis. It helps applicants determine if they meet the job requirements and sets expectations once they’re offered the position.

Of course, job descriptions tend to change over time as the business grows and evolves, and occasionally managers will revisit the job description and make necessary adjustments to set goals and expectations for the next year. This usually happens during the employee’s annual review,

Interestingly, a lot of business owners—including many independent agents and brokers—rely on formal job descriptions for the people who work for them but fail to develop a job description for themselves. Instead, they wear a lot of hats and just do whatever needs to be done.

Will they really let Obamacare fail?

By now, everyone’s heard the news: the Republican efforts to repeal and replace the Affordable Care Act have failed in the Senate. After three unsuccessful votes—first on the Better Care Reconciliation Act, then on a repeal and delay bill, then on a skinny repeal—majority leader Mitch McConnell declared on July 27 that “it’s time to move on.” For now, repeal & replace is dead, though the efforts could certainly be revived sometime in the future.

While there is much disappointment among Republicans and their supporters at this apparent failure, members of both parties are now saying that they need to work together on a bipartisan solution. Of course, time will tell whether this can really happen, but many lawmakers are saying that they’re willing to give it a try. In fact, a bipartisan Senate panel will be holding hearings on September 6th and 7th on stabilizing the individual insurance market.

What is Concierge Medicine?

As premiums continue to increase and plan designs are tweaked to keep costs under control, today’s health insurance policies are quickly turning into catastrophic coverage. They’re great if you have a big, unexpected medical expense but aren’t all that useful for some of the day-to-day needs like doctor visits and prescription drugs. Sure, members do get the benefit of the carrier’s negotiated rate if they stay within the insurance company’s shrinking provider network, but consumers are beginning to realize that there are other options outside the health plan that might help them save money while receiving better care. And as health insurance plans cover less and less, we’ll see more and more of these non-insurance solutions.

One solution that’s growing in popularity is direct practice medical care, sometimes called “concierge medicine.” Without the predictable office visit copayments that consumers have relied on for years, many people have started paying a monthly fee for unlimited access to their family physician.


The Internal Revenue Service has announced the 2018 deductible, out-of-pocket, and contribution limits for Health Savings Accounts. Compared with 2017, the minimum deductible will increase by $50 for people with single coverage and $100 for those with family coverage; the maximum out-of-pocket will increase by $100 for people with self-only coverage and $200 for those with family coverage; and the contribution limit will increase by $50 for self-only plans and $150 for family plans.

Is the Individual Mandate Going Away? (and what happens if it does?)

There are a lot of really good reasons to purchase health insurance:

  • Under the Affordable Care Act’s guaranteed issue provision, people cannot be turned down or charged more for pre-existing medical conditions. That means that someone who already has a need for medical care can buy health coverage to help them pay the bills; there’s not even a waiting period.
  • For those without pre-existing conditions, there’s certainly no guarantee they’ll be healthy forever. Nobody can predict what might happen in the future, and that, really, is why people buy insurance.
  • For people who qualify, the government will even help pay the monthly health insurance premiums and out-of-pocket medical costs. The ACA’s premium tax credits and cost sharing subsidies have helped millions of people obtain health coverage and pay their medical bills.
Is the AHCA good or bad for agents?

As lawmakers on both sides of the aisle debate the merits of the American Health Care Act and its possible effect on the poor, the sick, and the elderly, we thought we’d look at the proposed law from a different perspective: from the viewpoint of health insurance agents.

Is the pending legislation, good or bad for insurance advisors?

To answer this question, we must first look at the impact on your clients. Based on an analysis by the Congressional Budget Office, 23 million more people would be uninsured in the next 10 years if the AHCA becomes law, with 14 million people losing their coverage as early as 2018. Second, states that apply for waivers will see significant premium variations between healthy and sick people since carriers will be able to rate based on pre-existing conditions. And finally, older people nationwide will pay more as a result of expanded age rating.


As you know, there are a number of steps involved in running an agency and selling an insurance policy. Some of those steps, like answering incoming calls, explaining claims procedures when interpretation is not required, and tending to administrative matters can be handled effectively and legally by unlicensed personnel. Other tasks, though, require that an agent be properly licensed. Examples include providing insurance quotes, accepting an application, and receiving premium payments. The distinction is pretty clear, and most agents are careful about the duties they ask their unlicensed office staff to perform. There are some pretty stiff penalties for selling insurance without a license.

It shouldn’t be hard to understand, therefore, that the legal profession has similar rules about what duties must be performed by a licensed attorney and what information can be shared by people without a license – people like insurance advisors, for example.

What does this mean for agents? 

California Consumer Privacy