Whew. What an ordeal that was. I met with the church committee at 1:30 - just got home a bit ago. They have not cancelled their group yet like I was told. They have Empire Blue Cross, 80/20 PPO with a $200 deductible and the cost per family is $1,596 - single is $532.
First of all, they basically have no broker. Someone simply called Empire years ago, they assigned them to some broker who won't return their calls. I'm stunned - it's a huge group. I thought it was just this parish, but the entire diocese is yanking the group plan effective Jan.
And it's pure insanity. Fist off, it's insane they have a $200 deductible plan. Secondly, it's insane that the diocese is paying 100% of the family rate. You heard me, the employee and entire family are free. What church can afford $1,500 per month per family?
Ok, so I was thrown to the wolves sitting around a table of 12 people who were thinking they were losing health coverage in 2 months. Conditions? You name it - diabetes to autism and everything in between. Going with indie plans for everyone would be a cataclysmic mistake and nightmare.
Obviously my recommendation was to look at other group carriers and plans with much higher deductibles. A few kicked and screamed at that recommendation until I went over what an affordable indie deductible, OOP and drug deductible would be. That shut 'em up pretty fast. On top of that they were also informed that the diocese would not be able to legally reimburse them for indie plans. That was the nail in the coffin - definitely sticking with group.
So now I have a week to gather up a ton of group proposals and meet back with everyone including one of the head's of the diocese who makes the call. This will be a fantastic group case for me!
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3 comments:
I've worked on 3 groups and 4 different individuals and I'm starting to think I hate doing individual. The groups have been a lot easier and certainly more grateful. I think I just need to get some more under my belt but let's face it they all want family coverage for $200 a month with copays and a low deduct. I could scream! I'm waiting on deal that's 40+ people that I proposed early this week, fingers crossed.
Next time you should a be more proactive and provide a quick briefing on what a diocese is so people like myself don't have to take the 10 seconds I used up today googling that term.
Congrats on the group case. I'd be curious to know why only group coverage is reimbursed, while individual coverage isn't covered.
Because the DOI's are scared that if employers are allowed to pay for individual coverage they'll cancel group and the sick will be left hanging out to dry.
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