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Day Of ICHRA or QSEHRA Open Enrollment

We can execute a successful open enrollment in person or via Zoom!

Scenario 1 In Person:

When a Certified Health Advisor arrives for your Company’s ICHRA / QSEHRA Open Enrollment, you will’ve already agreed to the defined contribution amount for the employees to use (go shopping with)

For this example, we’ll assume the agreed employer contribution amount is $500 per month!

Usually, the employer will have selected an area for our Certified Health Advisor to set up. 

We like to be out of the way so as not to impact the flow of your business! 

A private area works best so that each employee can safely and securely provide the necessary PII – Personal Identifiable Information to enroll in a plan!

Our Certified Health Advisors will conduct an analysis for each employee to help determine the “right fit plan”! Each employee will be able to view rates from every health insurance company doing business in your state via the ACA Marketplace! 

Our Advisors will be able to explain the small print (this alone will help everyone save thousands) and help each individual employee come up with a total plan and not just a policy! 

A very popular strategy is our Gap Insurance 4 Health Insurance strategy! 

Everyone wants the lowest premiums with the lowest copays and the lowest out-of-pocket maximums.

Usually, a plan such as this will not have the lowest premium but the highest premium.

Let’s assume a premium of $800 per month for a low to zero deductible plan with a low maximum out-of-pocket.

After the employer contribution of $500, the employees’ portion of the bill is $300 per month! 

In this scenario, even with the lower deductible and lowered out-of-pocket maximums, the employee could still be left owing a couple of thousand or more in out-of-pocket expenses, along with still paying $300 monthly for their premiums.

The better option is to allow one of our Certified Health Advisors to use gap insurance for health insurance strategies to help lower monthly premiums and lower out-of-pocket expenses down to as little as zero!

Expert Tip #1

Select a lower-cost plan with a much higher deductible or higher out-of-pocket maximum!

Instead of the policy costing $800 per month for the “Mercedes Benz Policy”, select the high out-of-pocket maximum policy costing only $350 per month. (A total monthly savings of $450 or $5,400 per year per employee as an average.) If you have 25 employees, we’re talking about an example savings of $135,000 per year in pure health insurance premium cost! After 10 years of annual rate increases, we’re talking $2.45 million in total pure health insurance plan savings! 

It’s not just about what you’re paying this year as a business owner. It’s about Tomorrow and 10 to 15 years into the future! If you can save $3 to $5 million over the next 15 years, will this help you retain good employees while providing you with more money to expand your business instead of spending it on health insurance premiums?

The Al-A-Carte Gap Insurance 4 Health Insurance strategy, combined with an ICHRA or QSEHRA, can become a complete game changer for you and your employees!

NOW! We understand that most employees don’t have $10,000 sitting in the bank they can use for out-of-pocket expenses, and even if they have $10k in the bank….do they really want to spend it on health insurance bills? 

 *Research data has uncovered the number one and two reasons as to why someone would be admitted into the hospital for a day or more, triggering your deductible and out-of-pocket coinsurance maximum! 

An Accident or Critical Illness*

Instead of paying $800 per month for a low out-of-pocket maximum health insurance policy, why not go with the $350 policy and then purchase a $10,000 to $15,000 accident plan costing $30 per month? Why not also purchase a $10,000 to $15,000 Critical Illness plan costing $30 to $40 per month?

If you go to the ER for an Accident, let’s say a car accident, the average cost could range from $15,000 to $50,000. 

According to the National Highway Traffic Safety Administration (NHTSA), the average cost of medical treatment after a car accident injury is about $15,000. Furthermore, the average hospital bill for an emergency room (ER) visit is $3,300, the average inpatient hospitalization is $57,000, and the average air flight bill is $50,000. Medical bills and costs associated with hospitalization as a result of an auto accident can vary widely based on injury severity and the extent of treatments required. For cases involving serious injuries, like fractures or traumatic brain injuries, costs can exceed $100,000, especially if surgery, intensive care, or long-term rehabilitation is necessary. The Average Cost of Medical & Hospital Bills After a Car Accident

A $30 Accident plan with a $15,000 coverage amount could step in to pay your coinsurance maximum portion of the bill! If you have a $10,000 maximum out-of-pocket health insurance plan, the $30 monthly premium Accident plan would not only cover your out-of-pocket health insurance expense but leave you with $5,000 extra in the bank! This results in a ZERO out-of-pocket expense with 5k extra, all while paying a much lower health insurance premium!

The cost of experiencing a Critical Illness such as a Heart Attack, Stroke, Cancer, Coma, Severe Burns etc etc could easily cost $250,000 or more! 

A $30 Critical Illness plan with $15,000 of coverage could step in to pay your coinsurance maximum portion of the bill! I’ll usually select an amount double the maximum coinsurance cap!

If the coinsurance maximum is $10,000, I’ll select a plan for at least $20,000! This will give you enough money to pay your portion of the bill, leaving you with an extra $10,000 in the bank! 

The leftover money can be used for whatever you want! The obvious use of these funds would be to help replace your income while out of work and recovering from your accident or critical illness!

Special Note: I’ve had clients who purchased a $500,000 Critical Illness policy and received $367,000 from the policy when they suffered a critical illness. This money allowed them to retire early! Only $17,000 of this amount was used on medical bills! They were able to retire early without having to touch their retirement nest egg!**

Recap:

We took an $800 monthly premium down to $350 per month. 

We combined the lower-cost health insurance plan with two critical gap insurance plans….a $30 Accident Plan along with a $30 Critical Illness plan, bringing the total benefit plan cost to $410, still saving almost $5,000 for the year ($4,680)

The final piece to the puzzle is adding in a $33 Hospital Indemnity plan! 

A hospital indemnity plan will account for any other reason as to why you would have an ER visit or hospital stay! 

With this plan, it could pay $1,000 or more per day up to 30 days, with some plans paying up to 365 days. If in ICU the daily amount will double for 10 days! 

NOTE: This plan will pay in addition to the accident plan and critical illness plan! 

If you were in the hospital for 2 weeks due to a major heart attack with all 3 of these gap insurance plans in place! Let’s assume 5 of these days were in ICU!  

The Critical Illness portion would pay $20,000!

The hospital Indemnity plan would pay out $19,000, along with a $2,000 hospital admission benefit for a total payout of $41,000! 

After you pay the $10,000 max out-of-pocket expense, you’re left with $31,000 in the bank while recovering! (Great For Income Replacement After Suffering A Major Health Scare) ***

Each scenario is different, but even with the lowest copay plan and lowest out of pocket maximum, you’ll still end up spending a boatload of money in out of pocket expense, especially if you factor in lost wages from work, lost wages due to rehabilitation, new future expenses such as medical equipment, new medications and life style changes due to the health event!

A health insurance policy on its own isn’t designed to account for the “Total Health Event”; however, using the Gap Insurance 4 Health Insurance Strategy, you can not only lower your premiums but also almost eliminate your out-of-pocket expenses while at the same time providing yourself a financial cushion!

RECAP#2:

An $800 premium used in this example goes down to $350 per month, saving $450 per month.

We add a $30 Accident plan, a $30 Critical Illness Plan, and the $33 Hospital Indemnity Plan!

This leaves us with savings of $357 per month, or $4,284 per year, all while potentially reducing your total out-of-pocket expenses down to subzero! 

Using the $500 employer contribution in this example, the employee still has $57 left to purchase a Dental Plan! 

The process is simple: ***Increase your maximum out-of-pocket limits with your health insurance plan, which will lower your health insurance monthly premium, saving you hundreds or thousands.  

Add smaller, low-cost gap-style insurance plans to help eliminate your maximum out-of-pocket expenses!  Low-cost $10k to $20k supplemental gap insurance plans are far less expensive than paying for the best health insurance plan on the market! Use these lower-cost specialty plans to cover your deductibles and coinsurance maximum out-of-pocket expenses. This will not only cover your maximum out-of-pocket costs but could also provide you with extra money in the bank to help replace lost income due to your ER or hospital visit!

During the open enrollment process, each employee will receive a complete strategy to reduce health care out-of-pocket costs, along with reducing premiums, while helping to make health care more affordable!

If Zoom is used for your company’s open enrollment, each employee will receive a Zoom calendar invite to complete their à la carte open enrollment shopping experience!

This is a true à la carte experience for employees! 

As the employer, you don’t have to be in the plan selection business anymore! It’s now 100% customizable for every employee! 

This is the Gift Card Approach! The à la carte Approach! The Maximum Cost Savings Approach!

As the employer, you simply commit to a pre-defined contribution amount and allow my team of Certified Health Advisors to customize individual plans for each employee! 

This entire structure is made possible with the implementation of an ICHRA or QSEHRA! 

Open Enrollment Is Now Each Month Of The Year For Small & Mid-Sized Business Owners!

This is the Future Of Health Care!