How to Contact Me 9/23/2010 HEALTH INSURANCE NOT THE ONLY PLAYER ON THE FIELD

Transcription

1 HEALTH INSURANCE NOT THE ONLY PLAYER ON THE FIELD How to Contact Me Brought to you by: PPACA HAS LEFT US FEELING THREATENED RUN OVER CONTORTED INTO UNUSUAL POSITIONS SHOULD WE HANG UP OUR HAT? 1

2 YOUR GENERAL LIFE, HEALTH & ACCIDENT INSURANCE LICENSE Group & individual health insurance Medicare-related insurance products Whole life, term life, universal life Annuities Final expense plans Disability Insurance Supplemental insurance Cancer plans Critical Illness Long Term Care Insurance Dental & Vision Insurance MEDICARE-RELATED PRODUCTS MEDICARE S GOOD INTENTIONS PRETTY LITTLE CARD WHOLE LOT OF HOLES. TWO MAIN OPTIONS TO FILL THEM $1100 Deductible $275 daily coinsurance $550 daily coinsurance Anything after Day 150 $155 Deductible 20% coinsurance meaning..it does not cover While Medicare beneficiaries may also have access to programs such as Medicaid, VA, and several other types of coverage, for many the choice boils down to 2 primary options First 3 pints of blood $ Daily SNF coinsurance From Days % of chemotherapy 20% of radiation 20% of dialysis 2

3 OPTION 1: MEDIGAP SIMPLE CHART TO SELECT BENEFITS Also called Medicare supplements Plans and carriers that have been around since the 60 s Standardized plans make choosing a carrier easy No networks Medicare IS the network No referrals required Neat little handbook of what s covered and what s not Supplements pay after Medicare first pays If Medicare denies, the supplement can t pay Easy to understand once explained in laymen s terms Provide excellent peace of mind RATES VARY AMONG CARRIERS RETAIL PRESCRIPTION DRUGS ARE SEPARATE National average premium of approx. $37/month in 2010 SO EASY EVEN THE FEDERAL GOVERNMENT CAN FIGURE IT OUT MEDIGAP + PART D MIGHT SUIT Beneficiaries who travel and want to use their coverage anywhere in the U.S. Beneficiaries who sleep better at night if they pay one premium, and limit their exposure on the back end Beneficiaries who prefer the freedom to choose their own providers without any network restrictions 3

4 THAT WAS OPTION 1, NOW FOR OPTION 2 MEDICARE ADVANTAGE PLANS PRIVATE INSURERS OFFER VARIOUS TYPES OF PLANS REGARDLESS, MEMBERS PAY PREMIUMS, NETWORK COPAYS & COINSURANCE (Example only) Each plan has a summary of benefits that is uniformly designed to list the copays a member will incur for services, such as doctor visits, labwork, diagnostics, hospital stays, durable medical equipment and others MAPD MIGHT SUIT: Beneficiaries who are comfortable with some cost sharing in exchange for a lower monthly premium Beneficiaries who enjoy the convenience of having their plans packaged into one card Beneficiaries who can t afford or don t want to spend the premiums necessary for a supplement People who like extras ie, routine vision coverage BUT I DON T WANT TO: Figure out all those plans Have to deal with all those election periods Do all that certification every year Learn all that compliance Worry about Medicare secret shoppers Drive to old people s homes Now hang on minute.. 4

5 FIRST, IT S AN EDUCATIONAL SALE Explaining Medicare to older adults and their adult children is a rewarding experience. Your knowledge brings the consumer peace of mind, relief, and a sense of empowerment SECOND, IT S EASY TO QUALIFYFOR A SUPPLEMENT SECOND, THE MARKET IS CHANGING Open Enrollment Within 6 months of the month Medicare Part B begins Considered the best time to enroll in a Medigap plan Medical Underwriting 2 year history on many health conditions Chronic conditions Auto-decline medications Body Mass/Build Guaranteed Issue Within 63 days of termination of group coverage Certain special situations such as loss of prior plan due to moving, etc. SOME FACTS YOU MAY NOT KNOW Boomers are the first generation where the majority has had some form of higher education SOME FACTS YOU MAY NOT KNOW By 2030, the 65 plus population will double to about 71.5 million, and by 2050 will grow to 86.7 million people Source: Source: U.S. Census & 5

6 SOME FACTS YOU MAY NOT KNOW When year-olds were surveyed, 70% saw retirement as a time to stay active and begin a new chapter while only 28% saw it as a time to take it easy SOME FACTS YOU MAY NOT KNOW The first two years after leaving a job is typically a period of marital strife for retirees. Source: Source: SOME FACTS YOU MAY NOT KNOW Average baby boomer will live to be 83 FINALLY, LET S LOOK AT SOME NUMBERS FOR YOU Average medicare supplement pays level for 7 years Part D plans don t pay much, but they build loyalty Medicare Advantage plans pay on average $400/year for first time Medicare Advantage enrollees, and $200/year thereafter for several years (commissions vary by carrier) Source: LAZY AGENT, WORKS 15 HRS WEEK, HAPPY AT $40K Sells 2 Medicare supplements and 1 Medicare Advantage plan per week Conservatively, let s say each medicare supplement pays the agent $20/month And let s say half the Medicare Advantage plans were first year, and the other half were renewals/changes At the end of year ONE, he has earned: $15,600 in Medicare Advantage income $2080/month being earned in Medigap income Lazy happy agent starts year 2 at an approximate income of: $40,560/year MEDIUM ACTIVITY AGENT, WORKS MAXIMUM 40 HRS Sells 4 Medicare supplements and 2 Medicare Advantage plan per week Conservatively, let s say each medicare supplement pays the agent $20/month And let s say half the Medicare Advantage plans were first year, and the other half were renewals/changes At the end of year ONE, he has earned: $31,200 in Medicare Advantage income $4160/month being earned in Medigap income Medium activity agent starts year 2 at an approximate income of: $81,120/year 6

7 DID YOU KNOW? SO ARE THEY LAZY OR ARE THEY HAPPY? 97% of insurance agents make less than $75,000 year Source: Norvax University Source: Norvax University SERIOUS AGENT, BUILDS A BUSINESS AND A BRAND (WORKAHOLIC) Sells 8 Medicare supplements and 4 Medicare Advantage plan per week (note, that could be 6 appointments) Conservatively, let s say each medicare supplement pays the agent $20/month And let s say half the Medicare Advantage plans were first year, and the other half were renewals/changes At the end of year ONE, he has earned: $62,400 in Medicare Advantage income $8320/month being earned in Medigap income Serious agent starts year 2 at an approximate income of: $162,240/year DON T FORGET. Even the lazy agent has the power of renewals on his side. If he does nothing more than keep his clients, & maintain his current production level: Starts Year 2 With $10,400 in MAPD Renewals & $24,960 =$35,360 Adds: $15,600 in new MAPD & another $2080/mo. in Medigap Ends Year 2 Having: $26,000 in MAPD income Grown to $4160/month in Medigap income=$49,920 Approaching $75,920/year THE QUESTION THEN BECOMES: WHY DON T MORE AGENTS SELL IT? OR Scared of compliance! 7

8 SOLUTION? LEARN THE RULES IN A NUTSHELL A LITTLE READING AND SIGNING Meet with an FMO in your local area to learn about a few popular plans & get training Read through the Medicare & You Handbook & Contract with a Medicare Advantage carrier or two. MAKE TEXAS HAPPY MAKE CMS HAPPY Texas requires an 8 hour Medicare-Related products certification. Take the AHIP exam and complete your product certifications You can do this via classroom or online. Knowledge is power. 8

9 TDI & CMS WANT YOU TO MARKET ETHICALLY THE RULES ARE COMMON SENSE Don t be this guy! STAY AWAY FROM GIFTS & MEALS SPEAK THE TRUTH BE ACCESSIBLE LAST BUT NOT LEAST 9

10 JOIN A GANG (NO, NOT THIS GANG!) AN AGENT GANG! LEARN FROM YOUR PEERS NAHU BROKER TO BROKER Step 1: Log into NAHU website Step 2: Enter the Broker to Broker Forum Step 3: Post your Medicare question Step 4: Get answers from other agents, just like you, all over the United States SUPPLEMENTAL PRODUCTS HAVE YOU NOTICED THIS GUY? THERE HE GOES MLR WHAT MLR? 10

11 YOU WANT TO BODY SLAM HIM HIS WORLD INVOLVES NO UNSTABLE MARKET CONDITIONS WHAT DOES HE SELL? CANCER INSURANCE Estimated new cancer cases for 2010: 1,569,560 STABILITY Source: American Cancer Society THE NEED FOR INSURANCE The treatment of cancer treatment incurs costs that are often not covered by health insurance, such as: Travel Lodging Second & Third Opinions Experimental treatments Prosthetics Time lost from work Private Duty Nursing Home Recovery CANCER PLANS AIM TO MEET THESE NEEDS Plans designed to cover financial exposure while the patient focuses on healing. 11

12 PLAN TYPES First diagnosis, or lump sum benefit Per Incident or Ongoing treatment to policy maximums Levels of Coverage often Level 1 to Level 4 Optional riders Group or Individual plans VARIETY OF COVERAGE LEVELS PROVIDES SALES OPPORTUNITIES Plans as low as a few $$ month Mid-range plans High level coverage EARNING POTENTIAL Conservative sale of 1 cancer policy per week $20/month premium x 60% commission= $48/month THAT S A CAR PAYMENT Just choose your colors! At the end of one year, your incoming cancer plan commissions could be at least: $576/month CRITICAL ILLNESS WHY THE NEED? In the United States, somebody suffers a coronary event every 25 seconds This year an estimated 785,000 Americans will have a new coronary attack and about 470,000 will have a recurrent attack. It is estimated that an additional 195,000 silent heart attacks occur each year. An estimated 81,100,000 American adults (more than one in three) have one or more types of cardiovascular disease (CVD). In 2007, there were 4,048,000 visits to emergency departments with a primary diagnosis of CVD. On average, every 40 seconds someone in the United States has a stroke. Each year about 795,000 people experience a new or recurrent stroke. About 610,000 of these are first attacks, and 185,000 are recurrent attacks. Source: The American Heart Association: Heart Disease & Stroke Statistics, 2010 Update At a Glance 12

13 COVERS THINGS LIKE Daily Hospital Expense Benefits Blood/Plasma Surgical Expenses Oxygen Expenses Skill Nursing Facility Physical or Speech Therapy Transportation and Lodging Optional lump sum riders EARNING POTENTIAL Conservative sale of 1 critical illness policy per week $20/month premium x 60% commission= $48/month At the end of one year, your incoming critical illness plan commissions could be at least: $576/month ACCIDENT INSURANCE ACCIDENT INSURANCE AFFORDABLE PLANS OFFER PEACE OF MIND Look for plans that offer: Accident medical expense benefit Air and ground ambulance Accidental death Daily Hospital Confinement Dismemberment 24 hours day - worldwide EARNING POTENTIAL Conservative sale of 1 accident policy per week $47.50/month premium for husband & wife X 60% commission = $114/month At the end of one year, your incoming accident plan commissions could be at least: $1368/month 13

14 THAT S A HOUSE PAYMENT LIFE INSURANCE Just choose your neighborhood! LIFE INSURANCE QUOTES Term life insurance Whole life insurance Universal life insurance Final Expense plans Easy website calculators EARNING POTENTIAL Conservative sale of 2 life insurance policies per month Combined premium of $150/month premium X 90% commission = $135/month At the end of one year, your incoming life plan commissions could be at least: How often are you asking your clients? $1625/month THAT S A BOAT & MARINA PAYMENT (PLUS BEVERAGE MONEY FOR THE BUILT-IN COOLERS) Just choose your lake! LONG TERM CARE INSURANCE 14

15 MEDICAID CAN T SUSTAIN IT Long-term care is not just for the elderly, and it s not just about nursing homes. Roughly 40% of all long-term care insurance claims are made by people younger than 65. And most people receiving long-term care live in their own home or a family member s home. About 70% of people over age 65 will require some type of long-term care services in their lifetime. Of those, more than 40% will need care in a nursing home. Source: The Challenge: Mounting Needs and Costs Current problems with the provision and financing of long-term care will be exacerbated by the swelling numbers of the baby-boom generation needing care. These problems include whether people with disabilities receive adequate services, the potential for families to face catastrophic longterm care costs, and the burdens and social costs that heavy reliance on unpaid caregivers create(s) coupled with possibly fewer caregivers available in coming generations Taken together, Medicare, Medicaid and Social Security represent an unsustainable burden on future generations. Government Accountability Office (2005) CAREGIVERS SHOULDER THE BURDEN According to conservative estimates, the economic value of the unpaid, informal care friends and family provide nationwide is $306 billion per year. This figure dwarfs the annual national spending for formal home health care and formal nursing home care, which totals about $158 billion. BECAUSE MANY CAREGIVERS ARE BOOMERS 30 percent of boomers anticipate that their parents will move in with them. Source: the extension Foundation Source: Del Webb Survey, May 2004 BOOMERS UNDERSTAND THIS CONCEPT THEY AREN T AS OLD AS YOU THINK 15

16 THE PREMIUM SWEET SPOT EARNING POTENTIAL Conservative sale: 1 sales per month of a long term care insurance policy for a couple aged 55 in standard health Combined premium of $130/month premium X 60% commission = $78/month At the end of one year, your incoming LTC plan commissions could be at least: An American turns 50 every 7 seconds that's more than 12,500 people every day (U.S. Census). $936/month THAT S YOUR BLING MONEY Spend on whatever makes you feel like the rock star you are. SUMMARY HEALTH INSURANCE IS CHANGING MLR TO AFFECT COMMISSIONS AS EARLY AS JANUARY 1,

17 YOU CAN RUN YOU CAN HIDE BUT IT WON T WORK SEEK OUT OTHER AREAS WHERE YOU CAN STILL SERVE THE PUBLIC USING YOUR LICENSE Q & A 17