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Health Sales for Agents !A Future outlook

Clay Peek of Peek Performance , With Mark Peacock & Josh Hilgers of HPA present:. Health Sales for Agents !A Future outlook. Clay Peek of Peek Performance , .

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Health Sales for Agents !A Future outlook

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  1. Clay Peek of Peek Performance, With Mark Peacock & Josh Hilgers of HPA present: Health Sales for Agents!A Future outlook

  2. Clay Peek of Peek Performance, Contact info:“Insurance Exchange link”http://privateexchangebrokerblueprint.com/peek-performance-insurance/our Website:www.peekperformanceinsurance.com864-228-2635 officeclayp@ppisales.info

  3. Guest Speaker As seen in: Employee Benefits Adviser Benefits Selling Magazine CDHC Solutions Josh HilgersPresident, Health Partners America

  4. Things to watch for the next few months HHS Regulations Exchange Rules Essential Benefits ER Rules Medicaid Expansion Exchanges and Subsidies Running behind MLR Commissions

  5. How American’s GetHealth Insurance Now Group Employer – 145 million (incl. dependents) 2. Personal Policies – 40 million (up from 12 million in 2002) 3. Medicare– 47 million (incl. 12 million in MA) 4. Medicaid– 45 million (incl. 8 million over 65 or disabled) 5. Uninsured– 40 million (PC #, closer to 10 million)

  6. Shifting Roles - Employer • No plan or Defined Contribution platform important component in attracting and retaining employees • Choosing contribution and platform to offer • Reimbursing premiums in coordination with payroll • No minimum contribution or participation requirements • Health plan important component in attracting and retaining employees • Selecting plan for employees • Collecting money and paying carrier • Concern over funding and participation requirements

  7. New law could shift employee health benefits to private market The Supreme Court's endorsement of the federal healthcare law this week could spur more employers across the nation to relinquish their long-standing role as chief healthcare buyer for their workers.This shift has already begun among some big employers shedding their role in providing retiree health benefits, and experts say the court's decision this week could eventually lead companies to pursue a similar approach with current workers.With the Affordable Care Act still on track to offer numerous new benefits, such as guaranteed coverage for all adults starting in 2014, some companies may want to stop providing health coverage and instead give workers money to buy their own…. Chad Terhune 6/30/12

  8. Shifting Roles - Employee • Choice of any plan from any carrier available in state • Pay the carrier directly – Employer reimburses • Education and guidance on HDHPs • Complete insurance planning to maximize every dollar • No say in Employer plan – take it or leave it • Employer deducts premium contributions and pays carrier • Few Consumer Driven options • Health plan not always paired with ancillary and supplemental for optimal planning

  9. Shifting Roles - Broker • Focus can be shifted to sharpening sales and relational skills, bring new strategies to attract and retain employees • Multiple revenue sources from every case • Scalability achieved through efficiencies in system remove all limits to what you can handle • Majority of time spent on product specific issues: Quoting, Comparing, Communicating, Servicing • Commissions from one product make up majority of revenue • Limit to how many clients before capacity is reached

  10. How American’s Will Get Health Insurance 2015 Group Employer – 20 million (incl. dependents) Lose 125M here 2. Personal Policies – 185 million (more with GOP plans) 3. Medicare– 47 million (incl. 12 million in MA) 4. Medicaid– 45 million (less with GOP plans) 5. Uninsured –20 million Lose 20m

  11. How American’s Will Get Health Insurance 2015 Group Employer – 20 million (incl. dependents) From 28 million1 to 125 million2 consumers will change how and where they get their insurance in 2014 2. Personal Policies – 185 million (more with GOP plans) 3. Medicare– 47 million (incl. 12 million in MA) 4. Medicaid– 45 million (less with GOP plans) 5. Uninsured –20 million Sources: 1Congressional Budget Office, 2McKinsey Consulting

  12. We Have Seen This Trend Before 30-40 years to happen 3-5 years to happen

  13. ACA’s Impact on Individuals

  14. New law could shift employee health benefits to private market The Supreme Court's endorsement of the federal healthcare law this week could spur more employers across the nation to relinquish their long-standing role as chief healthcare buyer for their workers.This shift has already begun among some big employers shedding their role in providing retiree health benefits, and experts say the court's decision this week could eventually lead companies to pursue a similar approach with current workers.With the Affordable Care Act still on track to offer numerous new benefits, such as guaranteed coverage for all adults starting in 2014, some companies may want to stop providing health coverage and instead give workers money to buy their own…. Chad Terhune 6/30/12

  15. How are employers reacting? Reducing work force Reducing hours to < 28hrs/week Dropping Coverage

  16. Big Question for 2014 Do I offer group insurance or not? Factors will be: Size of group Average income of employees Costs – group premium vs. penalty etc…

  17. ACA’s Impact on Employers Some things to think about ER’s with <50 FTE EE’s have no 3k/2k penalty ER’s with no employee’s accessing a subsidy face no penalty ER’s offering qualified and affordable coverage can actually be hurting their employees Example

  18. Example: Family of 4 making $55k a year premium of $14,556. Single premium $5400

  19. Example: Family of 4 making $55k a year premium of $14,556. Single premium $5400

  20. Example: Family of 4 making $55k a year premium of $14,556. Single premium $5400

  21. Example: Family of 4 making $55k a year premium of $14,556. Single premium $5400

  22. Example: Family of 4 making $55k a year premium of $14,556. Single premium $5400

  23. ACA’s Impact on Employers If ER didn’t offer coverage - ER would pay $0, $3k, or $2k (depending on size of group and how many ee’s qualify for subsidy) EE would only be responsible for $4,135 and Gov. subsidy would cover the other $10,421 healthreform.kff.org/subsidycalculator

  24. Paying the penalty - http://www.nrf.com

  25. Paying the penalty - http://www.nrf.com

  26. Paying the penalty - http://www.nrf.com

  27. Market trends and studies

  28. “Exchanges are going to be a permanent, significant part of the healthcare world going forward because they are a powerful, adaptable way of meeting a variety of employer needs.” Oliver Wyman

  29. The Exchange Opportunity 2012 2015 CHANGE Rising CostsReformExchanges TraditionalGroup Benefits New/OtherBenefitModels Disruptive SolutionsDynamic Marketplace OPPORTUNITY What Models? 72% - Planning on Exchanges AON Hewitt survey of 562 U.S. Employers, Nov 2011 86% - Reduce costs 45% - Improve access to quality plans 43% - Enhance wellness programs 43% - Increase healthcare choices Why?

  30. How do you capture all this opportunity?

  31. Why This Is Important To You • Be the Go-to Service Provider • Become the market leader and choice service provider in this space • Increase Revenue • Additional product offerings • Additional revenue opportunities from non-insurance products

  32. DC/PRA Opportunity Defined Contribution Health Plan or Premium Reimbursement Platform will help increase sales and Participation Defining Defined Contribution • Group • Individual – (most likely to grow) • ERISA concerns will be gone

  33. DC/PRA Opportunity Defined Contribution Health Plan or Premium Reimbursement Platform will help increase sales and Participation by: • Incentivizing the employer • Creating tax savings for Employer to contribute or sponsor a product or plan • Creating tax savings to allow Employee to afford more coverage or other products they need

  34. Questions still outstanding • Will stand alone HRA qualify as “coverage” allowing groups who may be subject to penalty to avoid it? • Will individuals/families purchasing coverage with help from a subsidy be able to pay for their portion of premium with HRA/PRA? • Which premium payment method will carriers and employers prefer or adopt?

  35. The next 12 months

  36. DC / PRA – using personal policies High Level Overview of Defined Contribution Plans or Premium Reimbursement Arrangements (PRA) • Selling individual products in a group setting on a pre-tax basis • Marketing to groups that are underserved – No small group insurance offered • 60% of employers with 50 or fewer employees offer no benefits

  37. Keys to a Proper PRA Plan with Personal Policies Employees pay premiums out of their own checking account Employer does NOT offer small group insurance Employer not a part of the decision making process

  38. Tax Savings IllustrationsHuge Tax Savings for members and their companies

  39. Who This Solution is For • Companies with no health plan in place • Companies losing group coverage due to cost or participation • Companies with employees who are not eligible for the group plan • Companies with employees in multiple states • Many more companies will find this the ideal solution for ALL employees in 2014 but also great for non-participating and non-eligible employees now

  40. 2014 and beyond

  41. Shift to DC/PRA • Companies shift health burden to exchanges – offer defined contribution amount for ancillary benefits • Companies shift health burden to exchanges for some ee’s offer DC amount for health to others • Companies shift entire workforce to DC allowance for health and all other benefits

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