Top Solutions from Top Agents

With group health insurance prices continuing to rise, a gap plan can be an effective solution to lowering your group’s health insurance costs without comprising benefits. Our main product, the “Premium Saver”, is an employer sponsored group supplemental insurance plan designed to reduce the cost of group medical insurance. Premium Saver is not your typical gap plan. Brokers across the country tell us “It’s the broker’s secret weapon”.

With deductibles continuing to climb, many workers with health insurance through their employers, are struggling when it comes to out-of-pocket medical expenses. As we head into the busy season of the year, we wanted to share with you answers from some of our top insurance agents and how this plan is helping them to find a solution for their groups.

1. What is the most important thing for executives or HR directors to understand about Premium Saver?

Agent from TX: Because of the high cost of health insurance premiums, deductibles and out-of-pocket maximums, employees and their families are faced with financial decisions when they become sick and need to see a healthcare provider. By implementing Premium Saver into their company health plan(s) and reducing the member’s deductible and/or coinsurance, members will seek medical care in the early stages of their sickness. Healthcare costs are substantially lower when the member visits their health care provider as the sickness begins versus waiting days or weeks to receive care.

Agent from MI: The importance of giving the two cards to providers helps to avoid claim issues.

Agent from TN: We primarily incorporate Premium Saver into our level-funded and self-funded products. The main emphasis to our employers is that by incorporating Premium Saver into their benefits package, they will be able to provide a better benefit for their employees at a lower cost compared to typical insurance plans they review. The Premium Saver will also allow them to protect the integrity of their aggregate “claims” account and give them the best opportunity to receive monies back from their major medical plan. We offer Premium Saver to our fully insured clients as well, with the emphasis on it being a better benefit plan at a lower cost.

2. Do you think Premium Saver has a niche for certain size groups, specific industries, or groups experiencing change in the marketplace (renewals, carriers changing, networks shifting, etc.)?

Agent from MO: I tell brokers, if your group size is over 5 employees and has a deductible under $3,000, you should be looking at a gap plan to control costs and out-of-pocket expenses. I am seeing a significant increase in business submitted with level-funded groups. There are several carriers that give big discounts on major medical by going to a $6,000 or $7,000 deductible.

Agent from TN: We quote Premium Saver for every client we have and every new group we are privileged to quote. This allows us a “niche” in the marketplace, a competitive advantage, as well as the ability to provide savings and a better plan for our employers and their employees.

Agent from TX: Most employers, regardless of size or industry, are faced with annual rate increases and either pass the increase on to their employees or increase the deductible and out-of-pocket maximums. Premium Saver offers an option, regardless of size or industry, most employers are unaware of.

3. When your clients are reviewing their benefits at open enrollment, what is the #1 thing they desire when considering their health insurance options?

Agent from TN: Employers are accustomed to seeing double digit increases every year at renewal and are constantly having to make drastic changes to benefits to mitigate the increase. The financial impact to both the employer and employee is extremely difficult. Employers want to know how to keep their current benefits or provide better benefits to their employees at a reduced cost for the upcoming plan year, and what they can do to mitigate future double digit increases in premium. We can accomplish both things by incorporating Premium Saver into their benefits package.

Agent from LA: This depends on the audience. Executives and CFO’s are looking at the bottom line. Employees want more benefits, less out-of-pocket, and lower premiums.

Agent from TX: While many employers are forced to increase deductibles and out-of-pocket maximums, most desire to keep office visits and RX copays in the plan(s). Affordability, so employees can see their provider and get their prescriptions filled, would be number one.

4. In your mind, what is the #1 product differential of Premium Saver compared to other gap/supplemental plans in the market?

Agent from MO: Without a doubt, the #1 thing that separates Premium Saver from any other gap plan is the comprehensive coverage Premium Saver gives you. I only need to explain two exclusions; outpatient RX and professional fees at the doctor’s office. With other carriers, we need to go into further detail, such as mental health, substance abuse, durable medical equipment, and even lab tests. It is simple to explain and simple to understand.

Agent from TN: Premium Saver doesn’t have any gaps in its benefit design, whereas other gap products in the market do. The service we receive from Morgan White Group (MWG), in both customer service and claims, as well as the staff are the best in the industry. Product design along with impeccable service are what separates us from the competition and MWG has proven to be a great partner for us in both areas.

Agent from LA: Coordination of benefits, for sure. Other gap plans are indemnity plans or fee-for-service plans and do not pay like major medical, unlike Premium Saver.

5. Positive or Negative, what do you see on the horizon in your market?

Agent from TX: Very positive! More employers are being forced to move their health care plans to high deductible health plans. Premium Saver provides relief from the HDHP deductibles and out-of-pocket maximums. As we continue to educate both the brokers and their clients, companies will implement Premium Saver.

Agent from MO: Healthcare is an ever-changing marketplace and our government is now heavily involved in mandating both the service and benefits an employer is required to provide to their employees. As insurance agents and brokers, the burden is on us to be educated and vigilant in coping with these changes and to always think “outside the box” to remain relevant in the marketplace.

Agent from MI: Arbitrage is slowly eroding away. Loads are being placed on plans allowed. Positive: great renewals. Level-funded plans for the base seem to be the place to attack.