13. Current Situation This makes choosing health insurance: Subject to guesswork A choice between costs and quality Confusing Complicated Time-consuming Conflicting: costs versus employee retention
14. Covered and Protected We need health insurance to have coverage for: Expensive medical costs: hospitalizations, surgeries Immediate care in case of an emergency Costly prescriptions Peace of mind
15. How we Pay 1. Premium 2. Deductible 3. Co-Insurance 4. Co-pay 5. Max out of pocket The periodicamount that we pay for insurance coverage Usually paid monthly Age and location (state) are important determinants
16. Deductible Co-insurance Co-pay Max out of pocket Deductible A deductible is theamount you have to pay before insurance starts paying towards your claims. The higher the deductible, the lower the premium Exposure is limited by your maximum out of pocket Cumulative over the calendar year
17. Deductible Co-insurance Co-pay Max out of pocket Co-Insurance Co-insurance is a percentage of each claim you must pay. Your health insurance pays the rest. Insurance pays a portion, insured pays a portion Kicks in after your deductible has been met. Included in the cap on out-of-pocket fees Example: 80/20 co-insurance plan, $1000 claim: you pay $200, insurer $800
18. Deductible Co-insurance Co-pay Max out of pocket Co-Pay Co-pay is aflat rate we pay for office visits and generic name and brand name prescriptions. Most people valuetheir health insurance by the co-pay ”It only costs me $30 to see a doctor” A low co-pay can look like a good deal, but it can make health insurance very expensive. A lower co-pay generally means a higher premium
19. Deductible Co-insurance Co-pay Max out of pocket Max out of Pocket Max out of pocket is themost you will have to pay after your premium, given the worst-case scenario. When the maximum is met, any remaining applicable out of pocket requirements are waived for the remainder of the year. Co-insurance payments are included and accumulated over the calendar year. $7,500 is a common out-of-pocket maximum
20. The Right Policy To ensure you have a high performance insurance plan, you need to evaluate: 1.Premium 2.Deductible 3.Co-insurance 4.Co-pay 5.Max out of pocket Plus: youneed to think about how each plan pays small, medium and large claims.
21. Claim Levels Average annual claims by percentage of the US population*: Amount of claims per year: 92% of people have small, frequent medical expenses (<$1,200) which usually have little or no coverage under most health insurance plans. *Source: Watson Wyatt Worldwide
22. SuperAgent Web-based technology that provides independent analytic comparisons of group health plans in California All carriers and plans (400+) are included Brings transparency to the insurance purchasing process- reveals all hidden costs Designed for small businesses with less than 50 employees Graphs, charts, reviews and explanations help to understand your choices SuperAgent makes over two million calculations in less than twenty seconds.
23. SuperAgent Features Quickly submit your census: no data entry needed. Just click the people. Allocate your budget: set your contribution level based on a fixed amount, variable amount or as a percentage Compare your carrier and plans against all others. Review insurance carrier cost, quality of care, and customer satisfaction.
24. SuperAgent Features Plans are compared and ranked by value. Find the best plans for your budget and needs. Detailed quotes for each of your members. Dependant costs are displayed separately. Enroll and manage your group health insurance online
25. Benefits Save money- SuperAgent saves users an average of $700-$1000 per employee per year Feel empowered- confidently select plans with the best ROI Free, fast and easy to use- save time, money and energy Retain employees- by involving them in the process and by offering more competitive benefits Budget support: allocate your employer contribution wisely If you have 10 employees, this could mean you could save up to $10,000 a year!
26. Demonstration Would you like to: See how effective your current coverage is? Choose insurance plans based on quality and value? See how much money you can save per employee? Simplify your insurance purchasing decisions? Learn how to effectively manage your budget? We would like to show you a demonstration of the SuperAgent tool; see it for yourself.
Notas del editor
We all need good health insurance to pay for: (…), (…). But: how many ways do we pay for this?
We pay for health insurance in five ways. First, there is the premium. This is the base amount that you pay each month for insurance coverage.
After your deductible amount has been met, you no longer pay 100% of your covered expenses. You begin to pay a shared portion of them: the co-insurance (slide 3).
After your deductible amount has been met, you no longer pay 100% of your covered expenses. You begin to pay a shared portion of them: the co-insurance.
Choosing a health care plan solely based on low co-pay is tricky because there are many other factors involved that you need to take into consideration.Choosing your plan this way could get really expensive.
In conclusion, to ensure you have a high performance insurance plan, you need to evaluate:Premium costs AND deductibles AND co-insurance AND co-pays AND max. out of pocket limits.PLUS, you need to think about how each plan pays small, medium and large claims.
That is because insurance companies base their rates on the frequency of claims, have run the numbers and it turns out most people are overpaying for their insurance. Why is that? Most people have small, frequent claims. The statistics show that typically we all pay premiums as if we are that 8% with large claims. Why pay for coverage that you don’t use?? Why pay high premiums to cover 100% of unlikely medical costs?
SuperAgent is a new technology that will help you compare, evaluate and rank all California health insurance plans.SuperAgent has proven to save businesses $700-$1,000 a year per employee on health insurance, and we can do the same for your company.You can stop at this point in the presentation if you would like to go into the demonstration.If you want to show the benefits of using SuperAgent continue to the next slide