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Myth Busters of Buying Health Insurance Direct

Myth Busters of Buying Health Insurance Direct. Susan McGinnis, RHU Vice-President BenEx Insurance Agency. Myth No. 1. “I can save money by purchasing direct.” Wrong : In most cases, the products cost the same as if you purchased through an Agent/Advisor.

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Myth Busters of Buying Health Insurance Direct

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  1. Myth Busters of Buying Health Insurance Direct Susan McGinnis, RHU Vice-President BenEx Insurance Agency

  2. Myth No. 1 • “I can save money by purchasing direct.” • Wrong: In most cases, the products cost the same as if you purchased through an Agent/Advisor. • Insurance companies file rates with OID • Lose your advocate • Agent/Advisor usually saves your money by shopping and implementing strategic strategies

  3. Myth No. 2 • “I can buy online and save money.” • Wrong: • This is the same as purchasing direct with even more opportunity for discontentment. • Health insurance is not like buying music or a book • Benefits are complex, critically important and are different among insurers • Strong possibility for losing your Agent/Advisor

  4. Myth No. 3 • “I have a policy which I purchased direct and am locked-in.” • Wrong: • Typically an AOR is acknowledged but not paid if received during the first 12 months of the policy. • Advantage for you is that you have an Advocate/Advisor if/when needed.

  5. What to Expect From Your Agent: • Work with you to evaluate your needs for insurance coverage. • Explain the details of different plans - Group Health - Long-Term Care • Vision - Group Life - Dental - Worksite Marketing - Disability - COBRA/§125 • Make specific recommendations based on your needs and budget.

  6. What to Expect From Your Agent:(continued) • Serve as your advocate. • Communicate the benefits to your employees. • Review, Shop and Renew your plans annually. • There for you every day when you have issues arise with insurer.

  7. Insurance Company Ratings • Insurance companies are rated for a reason • AM Best • Weiss • Regulated by the Oklahoma Insurance Dept. • www.OID.ok.gov

  8. Individual vs. Group • Legitimate Tax Deduction • Portability • Guarantee Issue • Pre-Existing Condition Waiting Period(Federal Law limit is 6/12)

  9. Employer Size Does Matter • Cannot receive a Decline to Quote • Cannot get claims info • Can receive a Decline to Quote • Can Self-Insure • Can get claims info • Employer Decides • Definition of Full-Time • Employee Waiting Period • Contribution Amount/% Small Group (2-49) Large Group (51+)

  10. Oklahoma Coverage Options http://www.coverageforall.org/pdf/matrix/OK_Matrix.pdf

  11. State/Federal Subsidized Options: • Group – • Individual – • Oklahoma High Risk Pool • Temporary High Risk Pool

  12. PPACA (What’s Up?) • Patient Protection and Affordable Care Act • 2,500 page law • Phased-In over 8 years • US Supreme Court review • Health Care Exchanges per state • MLR

  13. Selecting a Agent/Broker Consider the following: • Bio (length & type of experience) • Employee Benefits Specialist (not P&C) • Professional Association activity • Look for active members vs. just members • Carriers appointed with • Licensee Look-up • https://sbs-ok.naic.org/Lion-Web/jsp/sbsreports/AgentLookup.jsp • Physical location/office • Support Staff • Nat’l Broker Agency vs. Locally Owned • Client Referrals

  14. Questions?

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