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3 ways to make ACA uncertainty lemonade for 2017

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Experienced health insurance agents and brokers have spent four years learning how the Affordable Care Act version of the individual major medical insurance market works, and now everything may be about to change.

Or not. No one really knows.

President-elect Donald Trump and many Republicans in Congress campaigned on the idea of wanting to repeal Obamacare. Some were vague about which parts of the Affordable Care Act package they think “Obamacare” includes, and they have shared different visions of what an Obamacare replacement package might look like.

Related: Rating agencies imagine gentle ACA repeal

Health policy watchers say Republicans might find that killing and blocking parts of the ACA is much easier than blocking or replacing the whole thing.

Related: GOP’s delayed-ACA repeal plan faces major obstacles

Analysts have started talking about the possibility that Congress could suddenly change the ACA system in the middle of the year, without providing transitional relief or an ACA replacement. In that scenario, insurers might dump policies or change major medical policy terms in the middle of the year.

Meanwhile, health insurance marketers need something to market.

Plenty are still selling ordinary individual major medical as hard as they can. A search for “Obamacare” on Google will still bring up a column of ads from exchange plan marketers.

Others are using a heightened version of a strategy that has been popular ever since major ACA changes began taking effect: Focusing on products and services not directly affected by ACA turmoil.

For a look at three ways health sector marketers are trying to turn 2017 ACA uncertainty lemons into lemonade, read on. 

WEX, a health account pioneer, greeted the arrival of a new type of HRAs by pointing out that it gets HRAs. (Image: WEX)

WEX, a health account pioneer, greeted the arrival of a new type of HRAs by pointing out that it gets HRAs. (Image: Twitter screen capture)

1. Reminders about expertise

Some companies are sailing past the uncertainty about individual major medical products by telling the world about their expertise, rather than promoting specific types of insurance products.

The consulting arms of insurance brokers, plan administrators, and plan support services vendors are in an especially good position to do this.

President Obama recently created a new type of health account option, the qualified small employer health reimbursement arrangement, or QSEHRA, when he signed the 21st Century Cures Act package into law. A QSEHRA gives a small employer a legal way to give workers cash they can use to buy their own individual health coverage. It’s not clear whether firms can really sell the accounts themselves at this point, but they can sell the support services employers can use to try offering the accounts, even though regulations implementing the new law are not yet in place.

Salt Lake City-based Zane Benefits Inc., an HRA administration firm, immediately began promoting PeopleKeep, a program that will provide support services for employers offering QSEHRAs.

Fargo, North Dakota-based WEX Health, a company that operates health account payment card systems, is using press releases and Twitter to point out that it too offers the tools employers need to offer QSEHRAs.

Many brokers are sending out e-mail newsletters and organizing events focusing on discussions about what the incoming Trump administration might do about health insurance in the coming year.

Related: Evolution, Lighthouse1 Complete Merger

Some marketers have ads that show up when consumers search for keyword combinations such as "obamacare" together with "uncertainty." (Image: Google screen capture)

Some marketers have ads that show up when consumers search for keyword combinations such as “Obamacare” together with “uncertainty.” (Image: Google screen capture)

2. Major medical alternatives

The Affordable Care Act exempts health care sharing ministries from ACA major medical mandates.

Individual major medical plans have to cover a standard package of benefits, without imposing annual or lifetime caps on those benefits.

Health care cost sharing ministries use members’ contributions to pay claims. They can charge what they want to charge, cover whatever they want to cover, set benefits limits however they want, and use medical and moral underwriting. They may exclude people with cancer, or people who disagree with their religious principles. They need not comply with state insurance laws and regulations, and it’s not always clear what other laws might govern their activities.

In some ways, they are like member-owned fraternal benefit societies that, unlike ordinary fraternal benefit societies, operate outside the modern insurance regulatory framework.

Issuers of some potential major medical alternatives, such as short-term health insurance, appear to be lying low during the ACA individual major medical open enrollment period, which runs from Nov. 1 through Jan. 31. Google searches for terms such as “obamacare alternatives” do not seem to turn up ads for short-term health insurance or hospital indemnity insurance.

Some searches for terms such as “obamacare alternatives” or “obamacare uncertainty” do bring up ads for health care cost sharing ministries.

Providers of health policy news and analysis, such as the Menlo Park, California-based Henry J. Kaiser Family Foundation, are also running Google ads tied to Obamacare uncertainty searches.

Related: 7 ways to turn ACA lemons into lemonade

Jeff Smedsrud is asking consumers for a flat monthly fee for a supplemental health benefits package. (Photo: Smedsrud)

Jeff Smedsrud is asking consumers for a flat monthly fee for a supplemental health benefits package. (Photo: Smedsrud)

3. Gap-filler bundles

In addition to health care cost sharing ministries, the Affordable Care Act major medical rules exempt the products typical classified as “excepted benefits. Excepted benefits are health-related products, such as dental insurance and long-term care insurance, that are free from federal major medical mandates.

Many readers, including Jeff Smedsrud, have been trying to lower dependence on sales of ACA-compliant major medical products by increasing sales of excepted benefits, major medical gap-filler products, such as hospital indemnity insurance, short-term health insurance and critical illness insurance.

Smedsrud, a former executive at Stamford, Connecticut-based Independence Holding Company and a co-founder of Miami-based Inc., an insurance lead-generation website, is now helping Thrivent Financial for Lutherans offer a package of excepted benefits through a membership organization,, for a flat monthly fee.

Instead of offering consumers a chance to buy products such as a health care discount card program, access to a medical debt negotiator service, and an accident insurance service for separate fees, is offering supplemental benefits packages.

The most expensive package, the Saver Maximum Plan, provides $5,000 in critical illness insurance, $5,000 in accident medical expense insurance, 30 days of accident hospital indemnity insurance, $10,000 of accidental death and dismemberment insurance, and 12 months of accident disability income insurance for $49.99 per month for an individual and $69.99 per month for a family. The high-end package also offers free, 24-hour telephone access to U.S. medical doctors.

The program is getting the insurance products from Madison National Life Insurance, an IHC unit that has its legal home location in Wisconsin.

On the web, some of the supplemental health products issuers especially visible on Google include Columbus, Georgia-based Aflac Inc.; Columbus, Ohio-based Nationwide Mutual Insurance Company; St. Paul, Minnesota-based Securian Financial Group Inc.; and New York-based Starr Companies.


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