What Sales Agents Need To Know About Rising Health Insurance Costs

November 9, 2016
Rising Health Insurance Costs

Rising Health Insurance CostsFor agents cold calling and sales prospecting health insurance leads this Open Enrollment, it’s a must to be up to date on the current situation. There are a great many changes taking place in the health insurance market, with rising health insurance cost top of mind for many customers. Coverage availability and options are also in more of a state of flux than they have been for the last several years. Your aged insurance leads may need help sorting through the headlines and evaluating their options. Here are the top three issues you’re likely to run into with leads this time around.

Premiums Are the Top Story

For most health insurance leads you’ll talk to this open enrollment, the monthly premium price point will be a top discussion point. It’s been the top news angle for the majority of recent Obamacare coverage, especially since the average Healthcare.gov Marketplace premium is set to rise about 25% in 2017.

However, on a case-by-case basis, the numbers vary widely. The bottom priced silver plan in Indiana is down 3%. Unfortunately, in Arizona, a comparable plan is up 116% cost-wise over last year. Most customers are going to see ACA plan premiums increase in 2017, however how that affects customers is going to vary based on some factors.

Many Qualify for Tax Credits

In some cases, consumers will be cushioned by tax subsidies. “This year, the vast majority of consumers will qualify for tax credits that help keep coverage affordable, and it’s easier than ever to shop around and compare options,” said Sylvia Burwell, Health and Human Services Secretary, in a recent statement.

Meanwhile, the Billings Gazette reported that 83% of Montana Healthcare.gov shoppers qualified for a tax credit in 2016, that’s about 48,000 eligible out of 58,000 customers. For those Big Sky Country residents, the average credit was substantial at $306, resulting in average monthly premiums of only $115.

Of those that don’t have health insurance or buy it on the open market, a good number are missing out on their own tax credit discounts and benefits. The HHS estimates about 14,000 Montanans are missing out.

Choice Could Be a Bigger Issue Than Cost

Meanwhile, the Oregonian wrote that “dwindling choice could be a trickier issue than rising premiums” this year, noting that there isn’t a “safety valve” for health insurance customers whose insurer exits the government program like there is for those whose subsidies cushion rising premiums.

Because of insurers leaving the Marketplace, some folks have been turned loose into the open market, perhaps for the first time in several years. In Indiana, some 68,000 people either have to find a new ACA Marketplace plan, venture into the open insurance market, or go without.

The Oregonian report identified Phoenix as the biggest loser regarding Marketplace choice for 2017, where all but one of nine 2016 insurers are exiting the state marketplace. That is a problem for some folks who require specific medications or treatments that remaining insurers may not cover. Consumers are also said to be concerned about whether they can keep their existing doctor and get care at nearby facilities.

Other Details for Agents

Whatever coverage decisions your health insurance leads make, they’re going to need to make them before January 31, 2017. That’s the cutoff date for this year’s Open Enrollment. Your leads may need more time to shop around and evaluate complex health care decisions than they did last year, but be sure to remind them that the clock is ticking.

As for tax penalties for lacking qualifying insurance coverage, the 2016 figures are the higher of $695 per person or 2.5% of gross income up to a household max of $2,085. The penalty rates for the 2017 tax year are likely to be similar, though it’s not yet finalized.

To help your clients, you’ll need to understand this current Obamacare environment and the most pressing concerns of your leads — premium costs, subsidies, and plan choices. Make sure you’re well versed in how these subjects affect your region before cold calling your next lead.

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