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FAQ’s

1. Are you a healthcare broker?

No. Typical healthcare brokers are paid a commission by insurance companies to sell their template plans. We work for our clients and are paid directly by our clients to analyze their existing plans and recommend improvements so there is no conflict of interest.

 

We are researchers, analysts, actuaries, accountants, consumer advocates, educators, and planners. 

 

2. Why hasn’t my healthcare broker told me about this?

Typical healthcare brokers are paid a commission by insurance companies to sell their template plans. We work for our clients and are paid directly by our clients to analyze their existing plans and recommend improvements so there is no conflict of interest.

 

3. Is this just self-insurance?

No. It’s a form of Open-Architecture Healthcare Plan Structuring which may or may not involve partial self-insurance. If a self-insurance plan is “too risky” then it hasn’t been designed properly and someone is ripping you off.

They should provide a guaranteed “maximum” spend that is far lower than a “fully insured” template plan. They should provided a guarantee that your costs will not increase by more than 5% a year. Most of our clients see 0% increases per year.

 

4. What happens if huge individual claims come in?

If you purchase the right amount of stop-loss coverage then you won’t spend more than the maximum guaranteed in your proposal. This max guaranteed amount should be far less than any plan provided by a healthcare broker.

 

5. What happens if total claims (or aggregate claim amount) is really high?

You won’t spend more on them then the aggregate attachment point. If you are, then your plan is not based on accurate statistical analysis and has not been structured for you properly.

 

6. How can you guarantee we will receive good service?

You can fire us with 30 days written notice. All payments to us will stop. Healthcare plans consist of several parts. We make sure each part is exactly what you need and working well. If one part doesn’t work well then we fix it. We’ve never been fired nor replaced with something or someone else.

 

7. It takes too much time and energy to switch plans – HR person is overworked…

Is paying less than 20% of what you currently pay worth it? Is 40% worth it. How much is this? Now take that 20% or 40% savings and project it out over the next 10 years. That’s a lot of money. Now take those savings and invest them. That’s even more money. For some of our clients this is worth millions of dollars. Isn’t millions of dollars worth it?

 

8. I’m too busy to provide a Census and Invoice.

This takes anywhere from 15 minutes to an hour for most businesses. The meeting  (or Webinar) showing you our analysis takes about one hour. Is that really too much? Is that too much time to find out if you are getting ripped off? Is that really too much time to give to discovering if you could save 20% per year and limit your increases to under 5%.

 

9. This won’t work for my ______ business because it’s in ______ industry.

Not true. This works for any industry. Manufacturing. Retail. Warehouses. Construction. Pharmaceutical R&D. Unions. Colleges and Universities. Non-Profits.

Business owners, CEOs, COOs, and CFOs always like the analysis and proposal.

 

Our biggest challenge is getting past, say, the HR director or someone else who doesn’t care because (a) “it isn’t their money” or (b)  they have a personal relationship with a healthcare broker or (c) get lots of  perks (like tickets, dinners, and other things) …from the healthcare broker.

 

10. Can’t you just send me something?

We could, but it’s all here on the website. Generalities and debating healthcare TREND data, Mercer Reports, and answering “I don’t get it” questions from the same people who created your mess in the first place are a waste of time. What is important are real numbers and details of plan structures. We need to compare Apples to Apples. What are spending? What should you be spending? What structure can provide the same benefits to your employees for the same or less money.

 

11. How do you get paid and how much do you get paid?

We are paid directly from our clients. We do not accept commissions from insurance companies. How much we are paid depends on the complexity of the plan and other details. There is no “fixed” percent or “hourly” rate per se.

 

12. Why hasn’t my HR or Benefits Director told me about this?

This is a highly specialized area of healthcare planning. Don’t blame them, they probably just didn’t know about us. The healthcare brokers they talk to don’t have any incentive to do this kind of planning even if they know about it. We also often find that healthcare brokers “wine and dine” HR Directors who are then reluctant to fire their “friends.”

 

13. Why hasn’t my healthcare broker told me about this?

Most healthcare brokers are really just “salespeople.” They are not researchers, statisticians, industry insiders, or tough negotiators. Salespeople just sell whatever template or service is provided by the insurance company which are created to maximize their profits. We are more like “Architects” and “General Contractors” who build plans to maximize your profits.

 

14. Can’t you just tell my broker what to do? I’ll even pay you.

No thanks.

 

(1) Why would you continue to pay the person who’s advice got you into this mess and why should we educated our competition? (Do you tell your competition how to be better?)

 

(2) If we gave them advice they’d run off and try to do it themselves, screw it up, and then you’d think our strategies were bad.

 

(3) We respect our time and your time, don’t work for free, and the longer you wait the more money you will lose. The faster we build these solutions, the more people we can help.

 

15. What should I do now? Is there any risk?

You should just send us a recent invoice and an employee census. (That’s a list of employees and employees family members who are on the plan, as well as their ages (or Date of Birth) and genders. You can blackout or remove their names.) You probably have these sitting around in a file cabinet or online. It should only take about 15 minutes.

 

Usually just on that basis, we can create an analysis within a few days that will be 95% accurate in terms of projected savings and plan structure. This is complimentary. We do not charge anything for this.

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