Breaking Into The group InsuranceMarket
Breaking Into The Group Insurance Market
Now more than ever, employers need an advocate to assist them in understanding how the Affordable Care Act (ACA) affects them, as changes to policies and procedures are guaranteed. That's where you come in! If you're looking to break into the Group Insurance market or are looking for support for your current book of business, Messer Financial Group is the perfect partner for you!
Reasons to sell group insurance
- Group plans can be sold all year long and are not regulated like the Marketplace.
- Group commissions are level and pay monthly as earned.
- Group is a great way to build a residual source of income.
How do I get started with selling group insurance?
- In every case, I would like to have a discussion with you and fine-tune what it is you’re looking for. A large percentage of Messer agents sell Medicare, Marketplace, and/or individual life insurance. If you fall into that category we can help you build a residual source of income. If you are an “All in Agent” interested in selling group insurance we have the ability to appoint you and assist as a back office.
- Complete and submit the group contract and call us today!
The Basics of Group Plans
Coverage underwritten on members of a natural group, such as employees of a particular business, union, association, or employer group. Each employee is entitled to benefits for hospital room and board, surgeon and physician fees, and miscellaneous medical expenses. There is a deductible and a Coinsurance requirement each employee must pay.
There are four fully-funded Medical Plans available and one Level Funded option:
- PPO - Preferred Provider Organization
- You are allowed to self-refer to any provider in the network. When using the in-network providers, the higher level benefit is received. This may be as much as 90% after the deductible. The benefit level for providers out of the network is typically 70% to 80%. Pre-authorization requirements must be met in or out of network. Providers in and out of network usually have a Doctor Office Copay
- POS - Point of Service
- Very similar to an HMO in-network plan. It uses a "gatekeeper" (Primary Care Physician or PCP) to refer cases to other in-network providers. Deductibles usually only apply to out-of-network care. Co-insurance is either 90% or 100% for in network providers. Services received out-of-network are typically paid at the 60% to 70% level. There are exceptions...typical an emergency while away from network providers or treatment required from specialists not available in-network
- HMO - Health Maintenance Organization
- The HMO uses a Primary Care Physician to direct all health care. No benefits are available outside of the provider network except when there is an emergency. HMO plans focus on wellness and preventive medicine and is the highest level of managed care.
- Indemnity Traditional Coverage
- The insured individual is free to use the doctor, clinic, or hospital of their choice. Both a deductible and a co-insurance apply and there are normally no co-pays for doctor office visits.
Long Term Coverage begins after a 60 or 90 day elimination period. Funds replace appoximately 50% to 66% of the employees income. Benefits can be from two to age 65.
Preventive Care - This plan normally pays 100%. A small deductible may apply.Basic Services - This plan is usually paid at 80% after a small deductible. It covers, but is not limited to, fillings, restoration, extractions and sealants.
Major Services - Usually paid at 50% after a small deductible. Examples of coverage include crowns, inlays, bridges, periodontic work.
Why is vision health important? You only get one set of eyes. Take care of them.
Your eyes not only affect how you see, but how you feel. Caring for your vision can lead to a better quality of life.
The plan will cover an employee for a flat amount equal to one, two, or three times the employee's annual salary. The employee may purchase additional coverage if desired at his/her own expense. Dependent family members may or may not be covered.
Our financial specialists can help you implement solutions to life insurance needs of any kind. Whether you are looking for a low cost way to ensure the well-being of loved ones, or to put a tax-sheltered investment in place that allows for maximum contributions, we can find the right fit for you. Out life insurance products range from Term Life to Universal and Variable Universal Life, and we represent over fifteen carriers.
How Does Level-Funding Work?
Level funding offers the same coverage and protection as fully-funded insurance plans, with the opportunity to get a refund on any un-used claims dollars. How does that work? The same as fully-funded insurance plans – a large portion of your premium dollars are put into reserves to pay claims. With level-funding plans, if your group has a healthy year they keep the claims dollars at the end of the contract term. Level-funded can be coupled with a PPO, POS, and HMO service platforms.
Reference Based Pricing (RBP)- a reimbursement calculation utilizing the Medicare allowance and mark up value; a reasonable level of reimbursement to medical professionals. RBP is rapidly gaining in popularity as a method to help clients control healthcare costs.
Group Insurance Resources & Tools
Steps for Successfully Completing Screen Fillable PDF Forms
Some of the PDF forms on this site are “fillable” on your computer. This means that you can conveniently complete these forms right on your computer by simply typing information into a form’s displayed fields. You can then print your completed form, sign it as required, and submit the form to the administering agency as you normally would via regular mail, fax, scan, or in person.
Please Note: Although you can fill in a form while it is displayed within your browser, we strongly recommend not doing so. Please download the form and open it in Adobe Acrobat to complete.
How To Fill Out A Fillable PDF
Follow these steps to complete a PDF Fillable Form
Download and Install Adobe Reader Software
To access, view, download, complete and print fillable forms you will need to use the latest Adobe Reader. Adobe Acrobat Reader is available for free and can be downloaded from https://get.adobe.com/reader/ Follow the instructions from Adobe to properly install the software.
View the Form, then Save.
Click the button that leads to the form you would like to fill out. When the form is open, select the download icon (or save icon depending on your version).
You might be given the opportunity to choose where to save your PDF form. Please make note of where you are saving it so you can open it in a later step. If you are not presented the opportunity to choose, it will be saved to your "Downloads" folder.
Open the Form and Fill
Locate the PDF file you saved in the last step in Windows and double click it to open.
When the form is open, Proceed to filling out the form as required.
Print The PDF Form & Process
When the PDF form is complete, select print.
If you are using the free version of the PDF Reader, you will not be able to save the form you just filled out, so it is important that you print it out right away. Mail or Fax the document as required to complete the process.
Signature Field Help
Your e-signature can serve as your legal signature.
Adobe seeks to make this process both easy and safe. Please follow these easy steps to electronically sign your Group Contract:
- Download the fillable PDF
- Fill out all applicable fields
- For signature fields:
- Click on the field
- A pop-up box will appear “Configure a Digital ID”
- Click “Configure New Digital ID” and click Continue
- Click “Create a new Digital ID” and click Continue
- Click “Save to File”
- Fill out the information that includes your name, email address (required), and business if applicable and click Continue
- Choose a password and Save
- Validate signature and enter password
- Document will re-save