Americans are currently awash in healthcare choices. With 14 individual state marketplaces and one very large HealthCare.gov, there is an average of eight insurance companies participating in the exchanges established by the Affordable Care Act in each state. Multiply that by the various plans offered by each insurer, and consumers are faced with a lot of choices.
Producers are increasingly helping healthcare shoppers navigate those choices, and along the way, they’ve developed definite opinions on the best available plans. With Dec. 23 right around the corner and business hours extending far into the night, choosing those plans quickly has become a matter of urgency.
For Neil Crosby of the National Association of Health Underwriters, three things characterize the best Obamacare plans: providers, pricing and premium.
“I call them the three Ps,” Crosby explained. “The benefits are all pretty much the same, so it comes down to a matter of price and providers. Really, we’re talking about who is your doctor, and finding a plan that has your doctor in it.”
For that reason, big name carriers like Anthem, Kaiser, Blue Shield and Health Net are the winners in California, said Oakland-based producer Denise Lombard.
“I do business statewide, and the fact that Anthem has the UC hospitals included is a big thing for people,” Lombard said. “I’m not happy with any of the networks—they are really hard to work around—but we’re trying to do the best we can with the networks that are available, and the smaller carrier networks are more limited.”
In Ohio, producer Joey Giangola with Giangola Insurance said he was happiest with plans from Medical Mutual for the same reason.
“It has a network that is extensive and you can receive treatment from a majority of doctors in your area. The prices vary, but it’s not enough to justify looking at something with less choice in my opinion,” Giangola said. “Network size will be your number one deciding factor.”
Not wanting to be counted out of the game, health co-ops like Land of Lincoln Health in Illinois have also made an aggressive play for market share and have had some success. According to LLH CEO Dan Yunker, the group shot for around 5% to 10% of Illinois’ market share in its first year and is currently “right in that range.”
Yunker said that more than 50% LLH sales made by producers are gold-level plans. He attributed the decision to the health co-op’s ability to offer not just a quality monthly premium, but affordable co-pays and deductibles managed by its own consumers—something small business advocate Elliot Richardson said is very attractive to the small group market.
“The fact that co-ops are governed by consumers within the co-op, and not shareholders, is something that’s immediately appealing to the small business community,” said Richardson, who works as CEO of the Small Business Advocacy Council. “What’s attractive to us is that small business owners will have a say and have some ownership in stabilizing insurance premiums.”
Richardson, who partnered with LLH in opening a private exchange, said producers have also been excited about the health co-op model.
“Brokers have been very hungry for another option,” Richardson said. “We have a list of brokers waiting to come on and sell our products.”
One thing all producers seem to agree on, however, is that qualifying for subsidies is an absolute must for all clients hoping to shop through government marketplaces.
“If you’re buying a plan inside of [the marketplace], it should mean you qualify for a tax subsidy to lower the monthly price of your health insurance policy,” Giangola said. “If not, you have no business buying from the marketplace.”