Monday, January 25, 2010

Small Group Health Insurance

Well, where is reform? More than ever small employers needs a change in the continually rising premium structure alongside benefit buydowns. We are still seeing 15-25% renewal increases for our book of business which could not be more frustrating given all of the talk of fixing this broken system.

One this is very clear, we need plan designs for small employers that keep premium stable, as such high deductible health plans are selling much more often, as consumer are starting to realize paying a substantially lower premium for say a 1500 deductible plan still allows that person to benefit from negotiated rates between physicians and insurance carriers, even though a "sick" visit in office may go "towards the deductible." So for example, your child gets sick, you have a 1500 deductible, and you take him to the pediatrician. The visit is 110 dollars, but the negotiated rate between, let's say Aetna, is 58.50...well, you pay the 58.50 at the point of service from the doctor, not the 110. That is good news as those of us with families, and that are in good health but each of us perhaps go to the doctor 1-2 times per year, a high deductible plan is perfect.

We need carriers to radically reduce premium structure on high deductible health plans - they have not yet, because they have not been forced by the government, YET...they are still GOUGING the consumers.

I am a married father of 4, and just bought an individual plan (though i own a small business myself!!) for my family for 288/mos from Humana with a 7500 deductible. It is better than not being covered, and also has preventive care and a good Rx card, which takes care of most of our normal charges. I look at buying my own health insurance just like car insurance now. I am willing to take on a big charge if something "catastrophic" occurs, but would rather pay a substantially lower premium that offsets our yearly charges for the care we have received on average for the last 10 years.

I hope more people continue to come to the Geeks so we can help you make the same kind of choices. It is obvious the government is not going to help us.

Tuesday, January 5, 2010

Financing of Health Reform

Well, not sure on this one....everything I read points towards a new tax on the wealthy, and surcharges on very "rich" plan designs or "cadillac" type insurance plans.

I wish the republicans and democrats could work out a truce, but that seems highly unlikely. We sell individual health plans, and small group plans all day long, and the same things are discussed with consumers of ours on the phone every day. We need a system where the healthy and the sick are insured all together, therefor providing affordable benchmark plans. The problem is the healthly folks who do not want to pay for insurance plans (who can blame them, they feel they do not "need" it right now) are not in the bigger pool, as such, the sick are left with high claims and not enough overall "premium" to fund the expenses. Then if the healthy become "sick" they then want to be able to jump in to the "pool" because now they need it...that's the GOTCHA, then any carrier in it's right mind "net's" those folks with medical underwriting to prevent folks adversely selecting against them. I have heard and seen this as long as I have been in this business, and that has been quite some time now. I think we need to have a mandate of coverage, similar to driving car without insurance coverage, and penalties alike, to get everyone sick or healthy in the "boat" together, as well as disbanding many of the federal and state mandated benefits, so we have a la carte coverage. If I want no Rx, no doc visits, just hospital (not even mental health) for myself and my family, give it to me - but do not charge me more than 200/mos for it, because that is really what this stuff should cost.