Using the Affordable Care Act to your Advantage

Presented by Leonard Berthelsen

It really doesn’t matter which side of the fence you’re on when talking about the Affordable Care Act (ACA). There are opportunities for just about everyone in our business. If you sell individual major medical coverage, you’ve probably found a way to embrace the new way of selling and dealt with the challenges that go with it. On the other hand, you may be one of those producers that say, “I’m certainly glad that I’m not in the major medical market so I don’t have to deal with all those changes”. There are challenges with every decision as well as opportunities.

With individual major medical coverage being offered through the ACA, many of these clients have affordable health insurance for the first time, especially if they are receiving a subsidy from the government for their premiums due to their income. They also found that they can qualify for the first time without their health being an issue. Unfortunately many are finding out the hard way that although their premiums are more affordable, the deductibles and co-pays required by these plans create high out-of-pocket costs. With the caps on these plans being $6,600 and $13,200 for an individual and family respectively, the question becomes how are they are going to pay for it.

This is where you come in. Don’t walk away from a discussion with a prospect that says they have their health insurance taken care of. Explore a little deeper with that client. Is it coverage being provided at work or is it an individual plan, what are the deductibles, what are the copays, what will it cost the family in out-of-pocket expenses? Products like, Critical Illness, Cancer Heart Attack Stroke plans, Accident coverage, Per Diem Benefits for Hospitalization and Intensive Care are all products that can fill that gap. In some respects, we are going back to the early 1980’s before Major Medical coverage for individuals was being discussed. The industry was selling Accident, Hospitalization, Medical/Surgical plans along with limited Disability Income protection as a means of plugging gaps that a client would have in respect to health coverage.

As we close in on another open enrollment period with the Affordable Care Act, keep the above in mind. You can do great things with these supplemental products for your clients but you have to have the conversation with them.

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