"I have a client, an early retiree, whose renewal premiums just went from $1,000 to $1,500 per month, and that was with a $2,500 deductible," says Stumpf. "Remember, Kansas is a relatively low-cost state for health insurance. We decided to go out and shop around and wound up finding an association-based plan that reduced their premiums significantly."
Would you know where to turn if a frantic client calls with news she's been denied insurance coverage at the very moment you've told her she's well-qualified to retire early? Or if premiums cost twice today what they did yesterday, thanks to a premium hike?
Expert health insurance agents and advisors should be able to shop hard for your clients. Alternate issuers with younger pools of insureds may offer lower-cost policies. It can also pay to shop association-based plans. Experienced agents will also be able to navigate the impact higher deductibles may have on policy pricing, along with the availability of catastrophic insurance, coverage available from the client's state high-risk insurance pool and self-insurance options.
Consider Self-Insurance
Some amount of self-insurance may be warranted, says Harold E. Foster, CFP, a principal of Financial Supermarkets Inc. in Paterson, N.J. Foster is the author of the new book Applying Medical Savings Accounts (Palisades Press).
He says tax-deferred MSAs can work well in conjunction with individual policies or catastrophic coverage (if that's all that is available to a client), by allowing the client to sock away relatively significant sums of money to offset deductibles, co-payments and uninsured treatments. If they never tap the money, it can be used for long-term care insurance needs or even retirement.
Increasing deductibles to an amount a client can comfortably afford-another form of self insurance-can also reduce monthly premiums and increase the odds a policy will be issued. "If you raise deductibles, say from $250 to $2,500 annually, you're much more likely to be offered a policy," Foster says.
Beware Of Better Service Offers
Doctors' bid to bolster their annual income and establish direct relationships with clients has led to some interesting new product and pricing schemes. Successful Washington, D.C.-based realtor Charlie Miller was shocked when he received an invitation from his longtime doctor to become a member of MDVIP, a doctor-led healthcare consortium promising to provide "a new level of preventative care based upon early detection and wellness planning."
How will they do it? By limiting doctors' client roster to a few hundred patients, instead of a few thousand. The price for the service? A hefty $1,500 a year, in addition to the $2,400 Miller already pays at age 62 for an individual Blue Cross-Blue Shield policy. "I was shocked," says Miller. "The only benefit I could see was not having to wait for appointments. That would have cost me $15,000 over 10 years." Miller didn't bite. But one or more of your clients may be tempted to, so it's important to let them know you're ready to have such offers vetted for them.
Know Your State High-Risk Pool Parameters
High-risk pools were mandated by Congress in the 1990s, but have yet to become the nationwide safety net lawmakers envisioned. While it's important for clients who lose or are denied private coverage to consider applying for insurance through their state pool, the subsidized alternative to private insurance is not a panacea. Only 29 states have created pools, and the insurance is expensive, often 150% to 200% higher than the average premium on individual policies would be, if your client were healthy. Still, state coverage can be a viable option for a client who has been denied coverage or can't tolerate private policy premium increases.
To qualify, a state resident must have been rejected by an insurer, have a catastrophic or serious medical condition or be insured by a policy that has premiums higher than the pool's. Still, it's important to investigate the pool's policies and requirements. Some states have very low lifetime benefit caps, such as California, which caps benefits at $75,000. Other states have a pretty stringent pre-existing lock-out period, some as long as a year.