BCBSNC Group Health Insurance Case Studies - Raleigh

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A selection of IBD Insurance Services case studies regarding group health insurance coverage

CASE 1

“We are a three person start-up company and want to get some group health insurance so we can save on our individual premiums.”

Our Review: All three employees are in good health and currently have good individual health insurance at reasonable rates. The company is projected to grow to six employees within the year and the company wants to have a health plan as an attractive benefit for new employees. After careful review of the existing rates and estimates of group rates, we found a group policy for three employees would cost more than what the three indivduals are currently paying.

Our Recommendation: We recommended that the company keep the individual policies for the next year. If the company wants to hire a specialized employee and feels that the employee has some significant health issues, we would then implement a group health plan that although may be a little more expensive than the current individual plans but would be much less expensive than the one valuable employee with a maximum rating.

CASE 2

“We are a thirty person company that has had the same insurance company for the last ten years, but are wondering if we are still getting the best rates for our employees. Our agent has always helped us keep our rates in line and we seem to be satisfied with her service. However, our increase is too much for our budget and we may have to make significant changes to our plan to meet our budget.”

Our review: A thorough analysis of the group revealed several issues that, together, would make a significant difference in the rates. We removed a 68-year-old to a medicare supplement plan, which reduced the group risk about 5%. We then found out that one employee was listed as a female rather than a male. This reduced the age/sex factors which reduced the rate by 2%. We then found that 3 employees had only one child on the group plan. Since the children were healthy, an individual plan would save about $120/mo for each employee but would have little impact on the overall rates. We then obtained quotes from six carriers based on the revised census and found the current carrier had the best overall rates. The rates were still more than what was budgeted.

Our recommendation: The changes reduced the rates some but not enough. We then modified the plan features to encourage the use of generic prescriptions and routine physicals. We also recommended developing a health awareness campaign to reduce utilization long term. The net result was a plan that met the budget needs and encouraged a healthy lifestyle which should keep future costs down, and helped four families reduce premium cost.

CASE 3

“My COBRA is expiring soon and I am concerned that individual rates will be very expensive, since I have some health issues.”

Our review: The individual was 36 years old with a history of high blood pressure, hypertension and high cholesterol. His COBRA premiums were $220/mo. His COBRA is to expire within the next twenty days. We have access to an extremely quick enrollment process and could have started a plan within the required timeframe. Due to our experience, we estimated his final cost to be about $320/mo and could be higher with the known health conditions. After further investigation, we found out that the reason why he waited so long to begin the application was that he just started his own business and did not have time to address his health insurance.

Our recommendation: We investigated the group insurance rate for a one-person company and found that the final rate, with a maximum underwriting code, would be about $226/mo. We therefore recommended that he begin a group health insurance policy. Since a group policy would take about thirty days to start, we also recommended a short term health insurance plan to cover the time between the COBRA expiring and the group plan taking effect.

NC Residents only

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Health Insurance:

Blue Advantage® [?]
Blue Advantage is a PPO plan that combines the cost savings of managed care plans with the freedom of traditional plans to choose any doctor.

Blue Options HSA^SM [?]
Blue Options HSA is a high deductible health plan that can be paired with a tax-preferred Health Savings Account

Short Term^SM [?]
Health insurance for individuals and families in times of transition and change for up to a maximum of six months

Medicare:

Medicare Supplemental [?]
Supplemental health care coverage for Medicare beneficiaries enrolled in both Medicare Parts A and B

Medicare Advantage [?]
A Medicare health plan that can combine health benefits and Medicare Prescription Drug coverage all in one

Additional Products:

Dental Insurance [?]
Quality coverage available to individuals and families with no network requirements and preventive services covered at 100%

Life Insurance [?]
Low cost term life insurance available from a wide selection of the industry’s most trusted companies

IBD Insurance Services, Inc.
3724 National Drive, Suite 110, Raleigh, NC 27612
Phone: 800 615-5980
FAX: 919 510-8876
http://www.ibdinsurance.com

ibd Insurance Services, Inc. of NC is an independent authorized BCBSNC producer/agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (BCBSNC). The content contained in this site is maintained by ibd Insurance Services, Inc. of NC. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.

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