ACA Means Great Opportunity

KFF_HealthReformInteractive-620x480Health Care Reform is upon us with open enrollment in October of this year. With that comes some great opportunities for agents and brokers. CMS recently issued a release defining the agent’s role in the Health Insurance Marketplace. It confirms our role in the exchange/marketplace as agents and allows for us to be paid commissions by the carriers. You can read the release here:

This means some great things for our business come 2014:

• Guaranteed issue individual product effective 1/1/14: This means you can now sell insurance to those clients who were previously declined or ridered, or who were forced to create a small group to get coverage.
Subsidized premiums for certain income levels: Premium for certain income levels: Premiums will be paid in part by the government for plan purchased in the Public Marketplace for people making between 133%-400% Federal Poverty Level, (between $11,490-$45,960 for a single or $23,550-$94,200 in 2013 numbers
Disbanding Small Groups: Smaller groups who will not face a penalty for not providing group health may disband their group health insurance policies and convert them to individual policies to take advantage of the individual premium subsidy. By going to the individual side, there will be no more friendly reminders to fill out the yearly MSP.  The new application for the individual subsidy and health application was just released. You can see a copy of the new application here:

Express Link:  Electronic link that will assist employees in enrolling in health coverage and make it easier for the employers to focus on more important things such as managing and growing their own business.

What is the Express Link?
Express Link is an electronic link BCBS provides you that embeds your agent information into the electronic application. This is a way for you to sell insurance policies now. In 2014 we hope that this will be streamlined with the subsidy application in the public marketplace or the “exchange”. Why wouldn’t you want to get paid for something that the Government is mandating?

Where can I find the Express Link

Express link is up and running now and you can use it today to sell BCBS of Illinois individual health insurance policies. There are just a few simple steps that you need to take to get started to help your Clients get individual coverage.

1. Go to the Hallmark Website
2. Click on Producer Services which is located on the upper right hand corner
3. Log onto your account
4. Click on Express Link which located on the right hand corner
5. Toward the bottom the web page, your very own personalized link is listed to access the OSC Online Application or there is also a personalized button code that you use to add a button to your websites.

Once you have access to your OSC Online Application, you and your Client can work together on picking the appropriate health plan to meet their lifestyle.
When can you start?

You can start using the Express Link option today. Open enrollment for the Public Marketplace plans starts October 2013 for a January 1st, 2014 effective date. Get ready for the great opportunity we all have in the individual market and get your Express Link up and running today.

If you have questions on how to access your Express Link, please contact us at 847-427-8000.

Where can I find more information on Health Care Reform?
You can visit our website at for more information including a video which is a condensed version of our Health Care Reform Seminar. As always, please feel free to contact us with any questions you may have.

Please remember to consult your lawyer and/or accountant for final guidance on any health care reform issues.

Small business will not have to pay a tax penalty if they choose not to provide health insurance to their employees.

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Health Care Reform is Here, Now What?

Retromatic (1)With ACA upon us, many brokers have been asking me what to tell their current clients?  Being a responsible agent and consultant, we all want to have fast and accurate answers for our clients.  Health Care Reform makes this almost impossible, not because we aren’t educated, but because a lot of the details aren’t released.  We need to get used to saying, “That detail hasn’t been finalized yet.”.  It’s difficult and can be uncomfortable as it’s something we are not used to saying, but it’s honest.

What is important is to learn what has been finalized so far, communicate that to your clients, and stay in touch with them throughout this year.  Answer the questions you can and explain why you can’t answer the others.  Showing your clients that you are educated will give them comfort in an unstable environment.  In times like these, people look for leaders and you need to be that leader.

Individual Plans

Starting with individual plans, anything written before March 23rd, 2010 is grandfathered and does not have to abide by all provisions in ACA.  Anything written after March 23rd, 2010 is non-grandfathered and will have to roll into 2014 ACA complication plans come next year.  We don’t know if these plans will all roll 1/1/14 or upon renewal starting 1/1/14. (Something that is yet to be determined).  What we do know is that those non-grandfathered individual premiums will most likely see a rate change as they are being rated differently under ACA.  They will only be rated based on age (3:1 ratio), location, family size, and smoker status (1:1.5 Ratio).  There will be no health rating, no gender rating, and included in all individual health policies will be essential health benefits including maternity, pediatric dental and vision, mental health and more (which currently are not included in most individual policies).  Policies will also be guaranteed issue with no pre-existing conditions.  All of these factors combined will change the rating structure, so prepare for a change.  If you have clients with grandfathered individual health policies we highly recommend keeping them grandfathered for as long as possible as we predict those rates will be lower than the non-grandfathered, ACA compliant plans.

Group Plans

In the group market, groups with under 50 Full Time Equivalent Employees have no requirement to provide health care by law , just as it works now.  The employers will have to make a business decision if they wish to provide coverage.  The main difference between today’s market and 2014 is that there will be an individual guaranteed issue market where a sick employee will be able to receive coverage and possibly a subsidy from the government to purchase that coverage, based on income levels.  Come 2014, that moral obligation many employers feel to provide the guaranteed issue group health insurance will no longer be present.

We predict a handful of groups will choose to disband convert to individual policies.  If that happens, you need to make sure you are there to assist with that transition so you are their agent of record.  All indications show that agents will be able to sell in and out of the public exchanges.   This also increases your opportunity to cross sell other products as you will form more personal one-on-one relationships with the employees.  Invest is a good laptop to take with you so you can sit down one-on-one and enroll these employees into individual policies.

Stay up to date on Health Care Reform by visiting our website’s Health Care Reform Notes page,  visiting our Facebook page, and checking back here for more updates.

Remember, you need to guide your clients through this new world of Health Care Reform.  We will know more everyday and we will do our best to keep you up to date on the changes as they come.  As always, if you have any –questions, please don’t hesitate to contact us at 847-427-8000.

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How has Health Care Reform changed after the Supreme Court decision?

Since the Supreme Court’s decision I have received a lot of calls from brokers asking me about the “new changes” with the health care law. I know there has been a lot of headlines in the news about health care reform lately and it seems like a lot of things might have changed, but the bottom line is things are the same today as they were three months or a year ago.

The Supreme Court’s decision upheld the Affordable Care Act, only changing the States relationship with the Federal government over Medicaid funds. You can read the full decision here. The guts of the bill and how agents and insurance companies have been doing business was not changed at all.

The main ruling centered around the individual mandate, which forces every citizen to buy a qualifying health insurance policy starting in the year 2014. If an individual does not purchase a policy they will face a penalty/tax. 26 states sued the federal government arguing that this was unconstitutional, that the federal government cannot force an individual citizen to purchase a private product or face a penalty under the Commerce Clause or the Necessary and Proper Clause of the Constitution (Article 1 Section 8). The Supreme Court agreed on this point, that the “penalty” imposed on a person is not constitutional under these two provisions of the constitution. They did find, however, that Congress does have the power to tax, and this fee, labeled as such, is constitutional, and the Affordable Care Act was therefore upheld, with the exception of the Medicaid decision.

So in the end, the fate of health care reform came down to semantics. It’s a tax, not a penalty, and the Affordable Care Act survived.

The law is written with a lot of regulations to be set at a later date. I explain it to agents as a giant “Mad-Libs”. As we gets closer to a certain provision of the law being implemented, the regulations are written to clarify that portion of the law. Often times the regulations are re-written before implementation. There are a lot of unknowns in this law. As the each provisions comes, MIBS will keep you up to date on the changes.

At this time there are not a lot of changes being implemented. This will change as we approach 2014. The one change this year is birth control being covered as a preventative service (100%) starting August 2012 for non-grandfathered health plans. (To see changes that have already been implemented please visit our Health Care Reform Updates Page.) As we receive releases from the carriers we will send them to our brokers.

It’s important to remember that although there has been a lot in the news about the Affordable Care Act and Health Care Reform, nothing has really changed for us. It’s business as usual. As changes come down the line we will inform our brokers through e-mail releases, our website and our Facebook page. As always, if you have questions, please feel free to call our office at 847-427-8000.

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The Value of the Annual Review

Did you know there are over 2000 working hours in a year? When you think about it, taking a few hours each year to have a full annual review with your client is very reasonable task.

Being in the small group market, it may seem a little laborious to go through a full-blown annual review meeting. I understand it’s a lot easier to sit and build the relationship rather than talk numbers.  While relationship building is an important part of the sales process and it shouldn’t be overlooked, it shouldn’t be the only leg you’re standing on.  Each year you should be reviewing the plans, their benefits, pricing, billing structure and other details.  It is beneficial to you as the broker for many reasons.

First, giving your small group clients service on the large group level makes them feel special.  You are giving them service they most likely have never received before and taking work off their desk and pressure off their shoulders.  Without you, deciphering  the products and crunching the numbers ultimately lands on the owners desk.  If he can find someone he trusts to be his consultant, he can spend that time in other pursuits.  When this service is delivered properly, you most likely will also receive referrals.  If you don’t receive them automatically, don’t be afraid to ask for them!  If you have done a good job,  people will want to share the news.

Second, situations change.  With our current economy, businesses and individuals are having to make changes more often.  Annual reviews are important to ensure that the coverages are matching each individual situation.  Things are moving faster than ever.  If left unchecked, policies will be outdated quickly, leaving your clients unprotected.

Third, you are able to spot potential product gaps that need filling.  For example, if the company has a lot of young females, a short-term disability policy would be a great fit to cover absences for maternity leave.  Depending on the employer, you could offer it on a group sponsored or voluntary basis.  See who has their P&C coverage.  Bundle that account in every way possible so you increase your retention.

Lastly, you can catch mistakes.  Everyone is human (last time I checked) and that means mistakes happen.  By having annual review meetings we can catch these mistakes as soon as possible.  No matter how small the mistake, if left unfixed, it can build up over time and end up becoming a costly error.  If you are doing a proper review of your clients products every year and making sure they understand the bills they are paying, you will catch any billing errors if they happen to arise.  Your client is also more likely to understand and appreciate the value of their insurance and their agent.

So take the time and review all products with your clients.  Make them feel comfortable with their decisions and make changes when necessary.  You are much less likely to lose the group if you are aware of their needs.  Those few hours you spend on that annual review will be well worth your time!

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It’s Easy to Get on the the Web

Try this….go to Google and search your business.  What do you find?  If you don’t see an up to date website, a Facebook Fan Page, and LinkedIn, you need to make some changes.  Most people these days have smart phones or spend a majority of their day in front of a computer.  It has become second nature to “Google” everything, including prospective companies.  If your clients cannot find you online, don’t expect that phone to be ringing a lot.

In the past, it has taken a lot of time and energy to get your web presence up and running.  We are trying to make all that work a thing of the past.  MIBS has partnered with a few companies to help you launch an updated web page and create a social media strategy.    We want this to be as easy as possible so you can spend time doing what you do best, selling.

To get your website and social media sites set up, MIBS has partnered with Ken French at  For a monthly fee, Ken will create and maintain a website for you with the goal of distributing your insurance products.  Ken has a background in insurance and knows what needs to be done on the web to be successful.  His family owned a general agency in New Jersey, who sold to Benefit Mall a few years ago.  Ken opened his own business to continue to help agents, but this time with technology.  He has over 1700 likes on his Facebook Fan Page and one of the fastest growing insurance groups on LinkedIn.  If you are looking for help on your web page, feel overwhelmed by Facebook, or don’t even know where to start, is the place to go.

Another great web tool I would suggest is  This is an easy to use side by side web quoting tool you can embed into your website.  It allows your web visitors to quote, compare, and enroll all while on your web page.  In addition to the online quoting, you will have a back office tool that allows you to view and track all quotes ran online.

MIBS has affiliate discounts with both companies.  We know how difficult it is to stay on top of things these days, and we want to make it as easy as possible.  We also know that we are a team.  If you are successful, we are successful.  If you have any questions about these services or need help with your agency, please contact us.  We are happy to help you in any way we can.  We hope that these services in addition to HR Buddy will help set you apart from your competition and make you and your agency more successful.

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How Google Alerts Can Help Your Business

Wouldn’t it be nice to see what people are saying about you or your business online but don’t have time to search the entire web?  Google Alerts is your answer.

This simple, easy service allows you to set up alerts for keywords, and will send you an e-mail when something is written about your business on the web.  This is great for monitoring your online reputation for you and your business.

Currently Google Alerts does not seem to catch things posted on social media sites such as Facebook.  For that, I would suggest using

To start getting Alerts, visit, type in your keywords, frequency of e-mails, and what e-mail address to send the alerts to and you are done!

I think it would be best to set up Google Alerts for the following categories.

1) You Business Name:  Setting up Google Alerts for your business will help you keep tabs on what others are posting on the web.  Use your full name, or any acronym your customers may use.  When I did this, I set up alerts for both “Midwest Insurance Brokerage Service” and “MIBS”, I found out that “MIBS” is a programming technique and also stood for the “Mumbai International Boat Show” and the “Miami International Boat Show”.

2) Your Domain Name:  Setting up an alert for your domain name will show you when people are linking to your site.

3) Yourself:  Many might believe this to be vein, but in 2012, we need to defend our reputation online.  Knowing what someone is writing about you or your business partners is very important.  That new client who Google searches the owner of your company to find less than desirable information most likely will turn somewhere else.

4) Your Competition:  Not only is it great to find out about your own business, but also to know about your competition.  Are they moving in a new direction that would jeopardize your company’s competitive advantage?  Is there a major flaw with their model that you could take advantage of?  Keep tabs on it so you can make the most of these opportunities.

5) Industry Terms:  For MIBS, I have set up some Alerts for “General Agency + Illinois”, “Insurance Brokerage”, and terms that apply to our business model.  That way, if someone is on a message board asking if anyone knows a good General Agency in Illinois, I know where and when it was posted and can respond.

Google Alerts are very easy to set up, and will help you keep track of your name and reputation online.

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How Senate Bill 2068 Will Help Agents and Consumers

Included in the health care reform bill passed in 2009 is something called MLR or Minimum Loss Ratio. This portion of the law mandates that at least 80% of premium for small group and 85% for large group must go towards claims leaving the rest for administrative costs. As the bill is currently written, agent commission is considered an administrative cost.

This poses a problem to the insurance industry. To meet MLR, commissions have been cut, leaving the future of the health insurance agent in question. Agents play a very critical role in helping consumers find the best priced quality coverage that fits the consumer’s individual need. Because there are many choices when looking at insurance, it is hard for the consumer to pick a plan that suits them best. Agents are able to listen to the clients, understand their situation, tolerance for risk, expected claims, and find the policy that would best cover the client. When they evaluate the situation, they help the client save money by understanding their out-of-pocket costs and premiums. Agents also help clients at claim time, assisting in communications with the insurance carrier. If the role of the insurance agent is phased out, the client would have no one on their side helping them find the best product for their needs.

Senate Bill 2068 would remove agent commission from administrative cost, ensuring that the role of the insurance agent stays intact. This would be a great benefit to consumers as it will ensure they have access to professional and knowledgeable guidance from a health insurance agent.

MIBS supports Senate Bill 2068. We believe the agent plays a critical role in the insurance and health industries and want that to continue into the future.

To find out more about the bill or contact your Senators you can visit the NAIFA website.

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