So a colleague recently clued me in to a way that the free market is responding to the new reality of an Obamacare-dominated health insurance market. The good news is that the concept seems to be perfectly legit, serving the interests of both the client and the agent (and her carrier). The bad news is that the plan is only available in a dozen states so far, although it has been filed and is pending approval in almost all states (although it's available only from agents of one carrier).
Still, it's a fascinating glimpse into how one can "reverse engineer" a desired outcome. I'll let "Donna" take it from here:
"You're going to like this, it's damn brilliant. Basically we're offering a limited benefit product that's very cheap compared to Obamacare. Assuming that no major illnesses or injuries come up, it'll pay almost all of one's medical costs with no deductible. The capper, though, is that the plan has a rider that allows the insured, at their discretion (and with with no additional underwriting) to convert it to a major medical plan with a $3,000 deductible and 100% coverage after that.
That major medical plan runs until the insured's next open enrollment period. So, cheap insurance for as long as you need it, the option to switch to a major medical plan even AFTER you get ill (but not requiring you to pay for it until you need it), and a guaranteed transition to O'Care (which, being guaranteed issue, is the appropriate place for high risk individuals). I'm going to sell a boatload of this product, and best of all, nobody loses."
Indeed. The only real drawback I see would be the potential for the individual mandatetax penalty fine. On the other hand, I'm told that it's priced to have a lower premium than a "metal plan," even with the tax penalty
Now here's where it gets, well, weird: almost six years ago, the (now defunct) American Community insurance company rolled out a very similar plan:
"Called "Community Flex," it starts out as an accident policy (major claims are only paid for injury, not illness), with some coverage for doc visits, preventive care, and a drug discount card ... if you want more coverage, such is available through a "Gold Plan" buy-up. This gets you coverage for more doctor's visits, more preventive care, and better prescription drug coverage."
So, not exactly the same, but similar concept. Currently, my colleague's company is the only one (of which I'm aware) that has developed this new-fangled ObamaPlan alternative.
Be nice if there were others (hint, hint).
Still, it's a fascinating glimpse into how one can "reverse engineer" a desired outcome. I'll let "Donna" take it from here:
"You're going to like this, it's damn brilliant. Basically we're offering a limited benefit product that's very cheap compared to Obamacare. Assuming that no major illnesses or injuries come up, it'll pay almost all of one's medical costs with no deductible. The capper, though, is that the plan has a rider that allows the insured, at their discretion (and with with no additional underwriting) to convert it to a major medical plan with a $3,000 deductible and 100% coverage after that.
That major medical plan runs until the insured's next open enrollment period. So, cheap insurance for as long as you need it, the option to switch to a major medical plan even AFTER you get ill (but not requiring you to pay for it until you need it), and a guaranteed transition to O'Care (which, being guaranteed issue, is the appropriate place for high risk individuals). I'm going to sell a boatload of this product, and best of all, nobody loses."
Indeed. The only real drawback I see would be the potential for the individual mandate
Now here's where it gets, well, weird: almost six years ago, the (now defunct) American Community insurance company rolled out a very similar plan:
"Called "Community Flex," it starts out as an accident policy (major claims are only paid for injury, not illness), with some coverage for doc visits, preventive care, and a drug discount card ... if you want more coverage, such is available through a "Gold Plan" buy-up. This gets you coverage for more doctor's visits, more preventive care, and better prescription drug coverage."
So, not exactly the same, but similar concept. Currently, my colleague's company is the only one (of which I'm aware) that has developed this new-fangled ObamaPlan alternative.
Be nice if there were others (hint, hint).
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