When It Comes To Price Or Broad Choice Of Providers, Price Wins Everytime

priceisright “Looking for SB’s in the audience!”
 What are narrow networks? It’s real simple: narrow networks are made up of docs and hospitals that charge less for the same services than other docs and hospitals…..This proves that not all docs and hospitals within a broad PPO network  have identical  managed care contracts. It’s the SB’s that make up a SBPPO………..(type in “SBPPO” in the search box on this blog to learn what an SBPPO really is).
By Gillian Roberts
March 13, 2014

Brokers are well aware of the benefits and pitfalls of narrow networks. Recent polling by the Kaiser Family Foundation shows that consumers only seem to care about the upside to these limited plans — decreased premium prices. KFF found that only 35% of uninsured individuals and those purchasing private coverage on their own want broader networks on the public exchanges. Moreover, once the price differences of narrow plans are conveyed to those same consumers, the interest in broad networks decreases to only 22%.

Craig Hasday, chief operating officer of Frenkel Benefits LLC in New York City, says this tendency could erupt in the coming months. “They see they’re buying Blue Cross and they don’t realize they can’t go see their doctor on that plan,” he says. “And I’ve seen clients land on Medicaid products and they’ve never done it before and then — big surprise — there’s no doctors there.”

Misplaced coverage

Hasday says he got a call from one woman who was recently divorced, had substantial assets, but ended up on Medicaid. “She sounded literally desperate, and I’m a human being,” so he met with her, he says. “It took me a day to unwind the problem — and that’s without pay because brokers aren’t compensated for that. I think she did end up buying something on the [public] exchange.” He says brokers may get even more consumer crises across their desks because “the consumer will get slammed” by limited plans with fewer doctor options. It’s a problem for him because he’s completely focused on his group clients but when he gets calls from people who need help, he says it’s hard to say no. (LIFE IN THE REAL WORLD IS HELL!)

Not all public exchanges have limited networks that will put consumers up in arms, according to another broker in the South. Matt Cowan, president of Cowan Benefit Services, Inc. in Franklin, Tenn., says he’s received a few change requests from individuals who chose limited networks, but that’s been the exception rather than the rule. “There are still plenty of primary care doctors that are quality and accepting new patients,” he says, even on the most limited plan by Blue Cross that’s only available on the state public exchange. In fact, 37% of people have selected that most narrow option out of 69,000 people who were sold plans on the Tennessee marketplace, according to data released by the state as of press time. Cowan says Blue Cross has about 65% to 70% market share in the state overall. (VOTE DEMOCRAT IN 2014 IF YOU LIKE OBAMACARE!)

But he’s not necessarily advocating for that plan for everyone who comes through his door. “I think taking the time to evaluate and look at the price differentials between the two or three network options and explaining the differences, once people really look at the difference people are willing to pay a little more,” he says. His rate of signing people on to the limited Blue Cross plan is far less than the overall number on the plan. “More like 10% to 15% of my clients are on the most limited plan,” he estimates.

Amy Webb, president and owner of Saratoga Benefit Services in Moorestown, N.J., isn’t so sure that even her advice as a broker will help individuals and employees understand the true implications of a limited network. She’s steered most of her individual clients clear of her federally run state exchange’s narrow option. (SHE IS AN IDIOT)

“There’s so many changes, people are overwhelmed,” she says. “People who never had to deal with insurance decisions because they chose to be uninsured or were previously on an employer plan now have so many choices and now with the networks, they literally shut down.” (POOR BASTARDS CANT EVEN TAKE CARE OF THEMSELVES!)

She says brokers already have so much educating to do in initial coverage discussions with clients. “We want to keep it simple, get them into a plan and then after a year or two, we can show them the price differences and the possibility of going narrower,” she says. “It just leaves them open to much higher out-of-pocket exposures and the possibility of very narrow networks.” Out of the 25 to 30 individuals Webb’s brokerage has sold individual plans to in the last month, none have chosen the narrower network. (SHE MUST BE A BEVERLY HILLS BROKER FROM CALIFORNIA)

 

 

                

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