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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.

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.

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?

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.

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.


If you’re a regular reader of the AHCP blog, you know that we frequently stress the importance of client communications. Whether you focus your attention on employer, individual, or Medicare products, your customers need to understand their policies and keep up to date with important changes that could affect their coverage.

To help you with your communication efforts, we thought we’d give you three short client communication pieces, one for each market segment (employers, individuals, Medicare). Please feel free to email them to your customers or include them in your monthly newsletter.

A Three-Step Process to Get More Small Group Clients

In our last couple posts, we explained that CMS has extended the transitional relief for small employers until the end of 2019, giving healthier small group clients an opportunity to save on premiums for another year and avoid some of the rules applicable to ACA metallic plans. We also explained that taking advantage of this option may require these small groups to continue renewing their same plan year after year without the option of tweaking their benefits at renewal/re-issue time. For employers looking for greater flexibility in plan design, self-funding provides a great alternative; small-business employers with self-funded plans often save money by avoiding the modified adjusted community rating rules, and they have multiple plan options to choose from.

In this post, our message is that self-funding is not only a good option for your transitional small group clients but also for a lot of small-business employers who aren’t your clients—yet. Below is a three-step process that will help you recruit new small-business employers and grow your business in this lucrative market.

Self-Funding Can Provide Relief for Small-Business Employers

On April 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that individuals and small employers can continue their transitional policies to the end of 2019; previously, these “grandmothered” plans were set to expire at the end of this year.

Groups with a transitional plan continue to play by the old rules: they can still be rated based on industry, number of employees, gender, wider age bands, and health status. Employers who have chosen to maintain their old health plans are, on average, younger and healthier than groups with ACA-compliant metallic plans.

The extended transition relief is good news for these healthier small employers, but in order to avoid the new modified adjusted community rating rules they must continue to renew their existing plans year after year. For companies that in the past may have tweaked their plan designs every year or two at renewal time, the transitional plan option can be quite limiting.

Differences in A & B Effective Dates when Medicare Enrollment is Delayed

A weird situation came up the other day that we wanted to tell you about. One of the agents we work with received a call from a 68-year-old client who had not signed up for Medicare when he was first eligible. He was not yet receiving Social Security checks, so he was not automatically enrolled in Medicare Part A when he turned 65. Instead, the client kept the individual health plan that covered himself, his wife (who is under 65), and his eight-year-old granddaughter who he has custody of.

When the client received another double-digit renewal increase on his individual plan, the agent convinced him that it was time to go ahead and sign up for Medicare, warning him that there would be a penalty since he didn’t take Part B when he was first eligible.

The gentleman went to the Social Security office at the beginning of January to sign up for Medicare Parts A and B. When his card arrived in the mail, he noticed that his effective date for Medicare Part A was July 1, 2017 while his effective date for Medicare Part B was July 1, 2018. “Is this a mistake?” he asked the agent. It was not.

IRS Lowers HSA Family Contribution Limit

For the first time since HSAs were introduced nearly 15 years ago, the Internal Revenue Service has retroactively reduced the HSA contribution limit. In a recent press release, the IRS announced that it is lowering the maximum family contribution to a Health Savings Account for 2018 from $6,900 to $6,850. The change comes as a result of the new tax bill. The self-only contribution amount remains $3,450.

What employers need to do

While this may seem like a minor change, it can cause headaches for your individual and group clients.

California Consumer Privacy