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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. - PowerPoint PPT Presentation
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Myth Busters of Buying Health
Insurance DirectSusan McGinnis, RHU
Vice-PresidentBenEx Insurance Agency
“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
Myth No. 1
“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
Myth No. 2
“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.
Myth No. 3
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.
What to Expect From Your Agent:
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.
What to Expect From Your Agent:(continued)
Insurance companies are rated for a reason◦ AM Best◦ Weiss
Regulated by the Oklahoma Insurance Dept.◦ www.OID.ok.gov
Insurance Company Ratings
Legitimate Tax Deduction Portability Guarantee Issue Pre-Existing Condition Waiting Period
(Federal Law limit is 6/12)
Individual vs. Group
Employer Size Does MatterSmall Group (2-49) Large Group (51+)
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/%
http://www.coverageforall.org/pdf/matrix/OK_Matrix.pdf
Oklahoma Coverage Options
Group –
Individual – ◦ Oklahoma High Risk Pool◦ Temporary High Risk Pool
State/Federal Subsidized Options:
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
PPACA (What’s Up?)
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
Selecting a Agent/Broker
Questions?