SALES PLAYBOOK
Welcome The Multi-Practice Entity (MPE) segment of the healthcare market represents a significant new market opportunity for brokers looking to augment their book of business in the attractive physician and dentist disability benefits space. While MPE s have been around for many years, the ACA has made this a fast-evolving space, with new organizations being formed and physician groups testing the waters in different ways and structures almost on a daily basis. This playbook is designed to help you find and close new MPE clients as efficiently as possible. Our experts have assembled their collective knowledge and experience into a punchy, bullet-pointed playbook that we hope will prove valuable in your efforts. The new MGIS IncomeProtect Multi-Practice program provides an integrated, streamlined package fine-tuned over several years to directly address the often conflicting needs of these organizations. We hope you ll find it a powerful solution for your MPE clients and their affiliated practices. Our Regional Sales Vice Presidents (RVPs) are always eager to help you scope, plan and close cases in the MPE space. Please call directly 801-0-2400 or find the RVP for your region at mgis.com/contacts. INCOMEPROTECT IS THE BRAND NAME FOR THE MGIS/SUN LIFE INSURANCE PROGRAM DESIGNED ESPECIALLY FOR PHYSICIANS, DENTISTS AND THEIR PRACTICES. THE PROGRAM IS DELIVERED THROUGH A PARTNERSHIP BETWEEN MGIS, THE PROGRAM MANAGER FOR INCOMEPROTECT, AND SUN LIFE FINANCIAL, WHOSE MEMBER COMPANIES PROVIDE THIS INSURANCE AND BACK IT WITH STRONG RATINGS FOR FINANCIAL STRENGTH.* * Each insurance company relies on its own financial strength and claims-paying ability. Visit sunlife.com/us for current financial strength ratings.
The MPE Opportunity TARGET MARKET DEFINITION Organizations formed by multiple independent physician and dental practices for the purpose of improving business effectiveness; they may include non-physician healthcare providers (e.g. imaging centers, physical therapy practices). MPEs go by many names: PMO, ACO, IPA, etc. The characteristic that distinguishes them from associations is a central management/administrative unit that either makes the decision for the entire organization or significantly influences the purchase. Note while these have been around for many years, their growth has accelerated since ACA and many new ones are being formed. TARGET MARKET SIZE AND GROWTH The Affordable Care Act has accelerated growth in the multipractice segment of the healthcare market now expected to double in group premiums by 2019. 1 Total group premium value is forecast to increase to $635 million by 2019 1 BROKER REVENUE OPPORTUNITY Generate $220,000 of annually recurring compensation. (See page 5 for sample revenue calculation.) 1 Market forecast based on MGIS analysis of the estimated employer-provided LTD, STD and life insurance market from 2014 through 2019. Estimates assume the multi-practice segment grows from 10% to 30% of the combined healthcare employee market and are based on demographic data from LIMRA, the U.S. Census Bureau and the American Medical Association. )Premium estimates are based on MGIS proprietary data and industry sources including Medical Economics, The Journal of the American Medical Association (JAMA), Deloitte and Levin, Kaiser, Physicians Practice and Modern Healthcare. CONTENTS Welcome The MPE Opportunity Target Market Definition Target Market Size and Growth Broker Revenue Opportunity Target Market Needs MPE Central Management Needs Doctor Needs Meeting the needs MGIS Value Proposition Solution: MGIS IncomeProtect Multi-Practice Broker Revenue Opportunity Sample revenue calculation Summary: Benefit by Role Supporting Material Customer/Broker collateral
Target Market Needs The solution requirements in this market include the competing and often incompatible needs of the two main constituents in today s MPE organizations. Meeting the Needs MGIS has crafted a targeted benefits solution designed to meet the demanding needs of the various constituents in modern MPE organizations. MPE CENTRAL MANAGEMENT NEEDS The central management unit needs to attract additional physician/dentists/healthcare groups. With physician shortages looming, the central unit needs a program that provides more value than independent physician practices can obtain on their own. MPE units also need to reduce administrative overhead and keep programs as simple and streamlined as possible. This need is often in conflict with what independent practices are accustomed to. DOCTOR NEEDS MGIS VALUE PROPOSITION Provide sponsoring MPE a program with value that individual member practices may not be able to obtain on their own. Allow plan design and administrative flexibility tailored to the central sponsoring organization and individual practice needs. Deliver IDI supplement and business revenue protection to physicians, dentists, and their practices. Provide distributors a differentiated solution for clients, the sales support they need, and new/ enhanced revenue stream. The physicians and dentists in the MPE have the same disability insurance needs as independent physicians: supplement their Individual Disability Insurance (IDI) on a group chassis IDI supplement to increase overall disability income replacement ratio Amounts sufficient to meet reasonable replacement ratio Obtained without financial or health history underwriting IDI-like contract features and benefits Physician groups also want flexibility and customization with regard to plan design choices and administration. This typically creates additional administrative complexity and cost.
Solution: MGIS IncomeProtect Multi-Practice Program Program Overview A program that provides large group benefits and small group flexibility As part of the MPE, member groups will have purchasing scale and opportunity for big company features that individual practices may not be able to obtain on their own. Allows tailored plan design and administration for individual practices FEATURE AVAILABILITY Access to the entire product portfolio Triple/Dual Option for IDI Supplement customizing Physicians can be offered a choice of 2 or 3 options to supplement their IDI coverage LTD/STD combo Medical Professional Liability rider included In addition, member groups may select one of the following riders (a) Progressive Illness (b) 5-year infectious disease (c) Extended earnings TAILORED BENEFITS AND ADMINISTRATION Plan Design: Each medical practice can have its own plan design, or the MPE can select a single plan for all practices Billing/Administration: Individual bills can be sent to each medical practice or location. Bills for each practice can be sent to the MPE s central management team. Note MGIS will always assign one dedicated account manager to service all member medical and dental practices PRICING Medical practices are priced individually, with a 10% discount for LTD and Life applied to non-experience rated organizations. One common rate for MPE member groups may be acceptable in some instances, subject to MGIS Underwriting approval Experience for the MPE block, where available and applicable, may be utilized in assessing rate levels and setting prospective pricing 3-year rate guarantee for the MPE. There is a common renewal date for all practices. New practices can join at any time, but renew with the rest of the MPE on a common date Renewal analysis may be based on the entire MPE providing both scale and flexibility to target specific groups or across the entire MPE
Broker Revenue Opportunity SAMPLE REVENUE CALCULATION 10 Programs typically produce $220,000 of continuing revenue Average 200 people per MPE (40 doctors, 160 Staff) Average $1,000 annual premium per covered person Standard 8% commission Sun Life Bonus Plan average 3% of premium CALCULATION 200 people X $1,000 per person = $200,000 annual premium $200,000 premium X 8% = $16,000 $200,000 premium X 3% = $ 6,000 Total Revenue Per Case = $22,000 Total Revenue for 10 cases = $220,000 Hypothetical scenario for illustration purposes only. Underwriting Guidelines MAXIMUM BENEFIT AND GUARANTEE ISSUE Consideration of the number of eligible employees for the combined MPE will be made in our approach to setting Maximum Benefit and GI levels. PARTICIPATION REQUIREMENTS Effective enrollment strategy documented and in place Minimum of 100 covered employees Each individual practice must have a minimum of 3 covered employees, with at least 1 Physician and either 1 Nurse Practitioner or 1 Physician Assistant covered Minimum 60% of an MPE s eligible groups participate Minimum 80% of an MPE s groups have been in business at least 2 years OTHER REQUIREMENTS A written agreement exists between the medical/dental practices and the MPE regarding their relationship and business purpose. The primary business purpose is for other than providing value-added benefits. A central decision maker or influencer exists that can and will endorse and actively promote this to individual practices.
Summary: Benefit By Role The MGIS IncomeProtect Multi-Practice program provides compelling benefits for each key member of the MPE solution chain: SUPPORTING MATERIAL CUSTOMER/BROKER COLLATERAL Doctor/Dentist: Tailor overall disability income protection with IDI-like benefits and features on a group chassis MPE Central Management Team: Attract and retain medical practices by providing a program medical practices cannot get by themselves Medical Practice Benefits Administrators: Simple, no-hassles administration Broker-Consultant: Client acquisition and retention through better solutions A variety of marketing materials is available to support your sales efforts with MPE prospects, both in print and electronically. Contact your MGIS RVP or Sun Life sales representative for details and availability, or visit mgis.com/brokers/ incomeprotect-multigroup. KEY MARKETING PIECES INCLUDE: MPE overview flyer PowerPoint presentation Press release Blog post article Informative web landing pages Webinar Podcast
The MGIS Companies, Inc.. is a leading national insurance program manager with deep experience in building and managing specialized programs for medical professionals. We partner exclusively with highly rated carriers and focus on group disability and life, and medical-professional liability insurance for medical groups of all sizes and specialties, including emerging group structures and with unique insurance requirements. MGIS works exclusively through local brokers and benefit advisors. Founded in 1865, the Sun Life Financial group of companies serves millions of customers in 24 countries worldwide. Our insurance companies in the U.S. are leaders in stop-loss and employee benefits, providing our customers with a wide range of disability, life, dental, accident, and critical illness insurance products. Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 93P-LH, 12- GP-01, and 12-DI-C-01. In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Windsor, CT) under Policy Form Series 13-GP- LH-01, 13-LTD-C-01-MGIS, 13-STD-C-01-MGIS, 13-ADD-C-01-MGIS, 13-GP-LF-01, 13-LF-C-01-MGIS. The disability policies provide disability income insurance only. They do NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Insurance Department. This coverage does not constitute comprehensive health insurance (often referred to as major medical coverage ) and does not satisfy the requirement for Minimum Essential Coverage under the Affordable Care Act. Administration for physician products is provided by Medical Group Insurance Services, Inc. (MGIS), in all states, except as follows: in CA by MGIS Insurance Agency, Inc.; in NY by MGIS Insurance Agency. Product offerings may not be available in all states and may vary depending on state laws and regulations. Producer use only. 2016 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. All rights reserved. Sun Life Financial and the globe symbol are registered trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us. GLTDOT-PHY-5633 SLPC 27444 5/16 (exp. 5/18)