Tip #457: All This For 75 Bucks?

Walter owns a small commercial and residential underground utility installation business. His five employees are young males working outdoors (i.e., fit).

He hasn’t previously offered health insurance but his team (and a new hire candidate) wants coverage now. Given the demographic, they seemed an ideal fit for an underwritten Alternate Funding Plan. (Huh? Click here for a tutorial.)

We quoted multiple options with several carriers and, guarantee issue fully insured (i.e., ACA community rated) plans.

Turns out just three of the five wanted to enroll, so we pivoted to a different Alternate Funding carrier that writes groups down to 2.

Fully insured premiums for the group of three (plus one dependent) were $2,003/month. Alternate Funding was 11% less, even more if we used a no network referenced based pricing model. (If you can bear the suspense, I’ll explain in Tip #458.)

Then I learned two of the three are thinking about raising a family. When maternity claims hit, they’ll be better off in a fully insured pool, and even with a slightly more expensive plan (i.e., lower OOP costs.

Insurers pay brokers ~ $25/employee/month in the small group market. Is it worth it?

Only if you like working and, you think big! Look here.