Why SuperAgent?

Securing, Renewing or the Administration of small group health insurance may be one of the worst nightmares for the owner of a company or the person in charge of this process.

Insurance rates are constantly going up, health plans are hard to understand and compare as well as there is no objective way to see what insurance plans fit each employee’s needs.

Cost control, government interference, administration liability and the demand for quality insurance coverage add to the problem.

What SuperAgent shows in less than 2 minutes, is a cost comparison of 100 PPO insurance plans to see what carrier deliver the Lowest Cost Coverage (LCC) for a wide variety of claim scenarios. Then to immediately have the ability to have each employee privately pick the most favorable, Lowest Cost Coverage per dollar of insurance premium and out of pocket expense based upon the employees risk tolerance and needs of medical services.

What this means is that an employer and employee can balance costs and benefit as a science not as “surprise black box purchase”.

Current Situation:

People know that they need health insurance and many companies help pay the cost. What SuperAgent shows in 2 minutes is how much money is being wasted on the purchase of inefficient small group health insurance plans and how much money can be saved by switching participants to the LCC (Lowest Cost Coverage Plans)

All the major insurance carriers offer extremely competitive insurance plans and they also offer the worst health plans ever created. Deciphering what the good plans takes some understanding. Carriers all offer great insurance plans, but cloud the picture by offering 10 to 15 poorly performing small group health insurance plans. SuperAgent shows the plans that provide the greatest value based on age, dependency, tax bracket, and claims prediction.

Health Insurance Plans have this structure:

When you have group medical insurance, it is as if you get a pin number to access your account and a discount membership card. Your health cards from the carrier acts as an ATM Debit Card and a VIP Discount Card. The health card gives you authority and access to a large bank account that has between $5 and $6 Million Dollars in it. You can access this bank of money like an ATM machine to pay medical bills and spend as much of the money as you need in case of an injury and illness. In addition to this cash account you all get an admittance discount that can be worth more than the bank. The health insurance card gives you substantial discounts on all of the medical, pharmaceuticals, doctor and hospital charge you may incur.

If medical insurance was a bank vault it would be 100 stories high with each story having $50,000 available to you. When you purchase insurance you are given a key to every floor and your free access every floor you need and every dollar is available for withdrawal once you get trough the 1st story. Only the first story gives you limited access to the $50,000.

Here is how the 1st story access works.

There are 4 keys to the money, one secret vault and each access key (premium) is based on how big or small each of these keys are.

1. The Deductible Key or D-Key
2. The Co-Insurance Amount Key or CIA-Key
3. Out of Pocket Limit Key or OPL-Key
4. The Drug Key or Drug-Key
5. Doctor Visit Key or Doc-Key
6. Secret Vault Key or My-Money-Key

Here is what theses keys mean:

Deductible (D-Key) is the amount of eligible costs you pay for medical coverage before the insurance company opens their vault. The higher the deductible (the amount you pay) the lower the cost of the medical plan or premium.

Co-Insurance Amount Key (CIA-Key) and the Out of Pocket Limit Key (OPL-Key) are twin brothers. Together they establish the share of the medical expense that insurance company pays and the amount you pay for the medical expenses. Cost sharing occurs after your deductible has been paid by you. After the deductible you pay part and the insurance pays part. The CIA-Key has a label like 80%, 70% or 50% or some variation. This key could be very expensive if it were not limited in some way. If you have to pay 20% and the cost of care and you had $100,000 claim, that could mean that your co-insurance key could cost $20,000. So all CIA Keys have a brother called OPL-Key (“Out of Pocket Limit Key”). The lower the limit the better it is for you.

If a health insurance plan has a $1,500 deductible and pays 80% (80% CIA-Key) of medical expenses and has a $2,500 out of pocket limit (OPL-Key). Under this condition your $20,000 claim would look like this.

Claim		You Pay		Carrier Pays
$ 1,500		$1,500 / Deductible (D-Key)
$ 5,000		$1,000 / 20% Co-Insurance (CIA-Key)		$4,000 (80% Co-Insurance)
$13,500				$13,500
$20,000		$2,500		$17,500

When this OPL-Key is reached, it is as if have paid all the cost of admission and you have full access to the rest of the money in your bank. Which means if you have any further claims up to $5,000,000, the insurance company pays all of it.

The next two keys are very interesting keys. In the past these keys have been sold as really great values to people because they are like bathroom keys. Everyone seems to use them quite regularly. This means that you can have access to prescriptions and doctors for a fixed cost or co-pay, like $25 for a doctor visit or $10 for a generic drug. Most of the time, access to these money rooms do not make you have a D-Key (deductible key) to get in. The problem is having these keys are very expensive to obtain. By having a D-Key to these cost, your health insurance plans cost is substantially reduced,
based on your age, family membership and tax bracket

The secret vault is a concept that if you save money in purchasing lower cost health insurance plans and build your own bank or reserve, it is as you are not becoming the bank or insurance company.

What is self-insurance and why do we self insure?

Self-insurance is a concept that not everything should be insured. It is a very poor financial decision to purchase insurance for events that are likely to occur or can be paid out of pocket or from savings should a loss occur. The rule is: insure against large catastrophic losses (loss too big to pay for all by your self) which generally speaking are rare.

If you have a car and it is worth $1,000 does it make sense to buy liability coverage? Of course because you could damage other peoples’ property or create bodily injury, no matter how valuable your car is. On the other hand if it cost $200 to insure the car and the policy has a $250 deductible, why pay $200 to possibly recover $750. In just about 4 years you would have spent $800 in premium and probable not have a loss and if you did most people would be better off getting a loan and purchasing a replacement car.

Health Insurance should be purchased with the same strategy:

What are your chances of having yearly average claims of $150?
What are your chances of having yearly average claims of $1200?
What are your changes of having yearly average claims of $12,500?

Only 8% of people in the US have large average insurance claims of $12,500.
About 60% have small average insurance claims of $150 and about 32% have average insurance claims of $1,200.

If you are healthy living habits, exercise, and avoid hazardous avocation your chances of having large catastrophic losses are low. This is where health insurance really does the best job because you can feel that you are covered well with low insurance premiums and are still covered against a large financial loss. If you fall into the higher risk population then look at health insurance plans that deliver more money quicker with the lowest possible cost with coverage that will respond to anticipated claims. SuperAgent does the analysis and works for you.

In 2 minutes of analysis, SuperAgent will let you know which carrier’s health insurance plan will respond best with the lowest cost per benefit dollar no matter what your claim anticipation is. It will even recommend an insurance plan if you are not sure of what your claims will be based on your age, family membership and tax bracket.

Why is your tax bracket important in determining health insurance plan purchase?

A few years ago, congress passed a law that introduced a Health Saving Accounts. To encourage people to have health insurance, the law allows for people that purchase high deductible health insurance plans and to set up optional special savings account with a bank. These Health Saving Accounts can be funded by the employee or employer or both. The discretionary funding (limited to $2800 for 2007 for an individual and $5,600 for a family) is not subject to Federal Income Tax. This encourage people to have health insurance as these funds can be used to pay for expenses not covered by the plan like the deductible and co-insurance or for dental and vision expenses(even if you do not have these insured). Therefore if you are in a 15% tax bracket and you use the HAS account, it is like having a 15% discount because that expense uses tax free dollar out of the Health Savings Account to pay for that expense.