Open Enrollment Scenarios
(Originally emailed to agents on October 31)
In most every circumstance, you can save your clients money and keep them Blue! Here are the primary scenarios and a solution to each. All of what you’re experiencing in the market can be explained. Remember, much is the result of last-minute and unexpected changes that required rates to go up for 2018. This all happened on October 13.
1) No Advance Premium Tax Credit (APTC) & Off-Exchange
Do you have a client with a Silver plan, or being cross-walked into a Silver plan? You need to help him or her enroll in a different Blue plan. Off-exchange Silver policies — with every carrier not just Arkansas Blue Cross — are overpriced by 10-20%. Even an off-exchange Silver plan with a competitor will be overpriced because a big portion of premium is covering a benefit they won't get (being off-exchange).
- Why is this? This was a solution to offset the unexpected loss of the cost-sharing reductions (CSR). Remember, the Affordable Care Act still requires insurers to make out-of-pocket costs lower for members enrolling through the exchange.
- What is the solution? We now know Silver plans are clearly overpriced. Gold plans, for different reasons, are expensive and you have to look at the return on investment compared to buying a Bronze. To us, the clear winner is the Bronze Plan 1. The Bronze Plan HSA 1 is another great option. The smart play for off-exchange members is to stay Blue by going Bronze!
2) APTC & Enrolled in On-Exchange Silver Plan
Is the client's federal poverty level (FPL) the same? You can help him or her save money in 2018 by enrolling them in Silver Plan 2. Remember, approximately 85 percent of those enrolled in the Marketplace receive an APTC, so this strategy applies to the overwhelming majority of your current Arkansas Blue Cross FFM membership.
Example: Two 40-year-olds in Pulaski County with a MAGI of $27,000 are currently paying $207.64 per month (after APTC) for our Silver 2500 plan (rates differ a little by region, solutions remain the same). They would pay $135.41 per month if they move to a Silver Plan 2 in 2018. This is the best way to keep current Arkansas Blue Cross Silver members who receive significant APTC in a Silver plan.
2a) Same Scenario Above; Alternate Solution
Use the APTC to get an even better price on the Bronze Plan 1
Example: Two 40-year-olds in Pulaski County with a MAGI of $27,000 are paying $106.32 per month (after APTC) if they’re enrolled in a Bronze 6350 plan. Help them enroll in the Bronze Plan 1 (the new name of the Bronze 6350) and they would pay $20.89 per month in 2018. Another opportunity to save your client money with a Bronze plan.
Value of Blue
Your clients have a choice and you play a critical role in helping them with this choice. The value of Blue is real. We've described how the majority of your current Blue clients can save money (and keep similar or better benefits). What are some additional features Arkansas Blue Cross members receive? See the brochure for more details.
- Our robust, statewide True Blue PPO network includes access to more top doctors and hospitals through our BlueCard program in all 50 states. (Remember, select Arkansas Works plans in 2018 will not have BlueCard.)
- With the exception of HSA plans, all of our plans offer two free visits to the primary care physician (in addition to free wellness visits). And, unlike other carriers in the market, the Arkansas Blue Cross Bronze Plan 1 and Bronze Plan 2 offer copayments that are not subject to deductible for PCP visits (in addition to free wellness and two free PCP visits).
- Steep discounts with providers in our network. Regardless of copayment, coinsurance, deductible, etc., the negotiated discounts protect the member from being balance billed.
- Local access and accountability. We provide all stakeholders with an open line to representatives. Whether it is our regional presence for our members or our close relationship with our providers, this accessibility is a fundamental difference when choosing Arkansas Blue Cross. For agents, we provide you with second-to-none tools and training, access to live agent marketing support and an assigned individual product representative for escalated issues.
- Award-winning customer service and renowned member tools recognized for innovation (i.e., My Blueprint, Personal Health Statements, etc.).