Business Owner Major Medical Comparison 2

8/6/2019 Business Owner Major Medical Comparison 2

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Major Medical Cost Comparison



Insurance Commissioner Reveals Shocking Truth

That Americans are Paying Thousands Of DollarsToo Much For Their Health Insurance & What You

Can Do About It

• Would you like to learn what Insurance

Companies “Don’t” want you to know?



We Call It Insurance, but That's Not Healthy(By Lawrence H. Mirel - Commissioner of Insurance and Securities, Washington, D.C.)

• “The current system for paying the costs of health care isseriously flawed, because insurance is the wrong model --at least for part of the system.”

• “The general definition of an "insurable event" -- from

traffic accidents to tornadoes -- is something that :”

• First: is very unlikely to happen;

• Second: will come without warning; and

•

Third: is not something the person who is insured ever wants to happen.

(Excerpts From a Washington Post Article – 2001)



Two Different Tiers Of HealthCare

• To begin with, we must recognize that we are dealing with twodifferent tiers of health-care needs and must cover those needswith two separate tiers of payment.

• One tier is catastrophic illness -- and for that tier, insurance is theanswer

• The second tier comprises health maintenance and routinemedical procedures. For this tier, insurance is not the answer.Instead, I see other options: One is for people to pay these costs

out of pocket, the way we now pay for many other routineneeds, such as car and home maintenance.



Cost Analysis Major Medical

(Blue Cross, Blue Shield Of Texas)

www.bcbstx.com

John and Mary (Ages 51/48) - April 2011 (Houston, TX)

PPO Select Choice (Comprehensive Coverage)

$1,000 Deductible (80/20 Co-insurance)

__________________

$970.00 Per Month

http://www.bcbstx.com/

http://www.bcbstx.com/



Cost Analysis Year by Year

(Comprehensive Coverage - $970 per month)

$970 x 6 months premiums = $5,820

$25 co-pay to the Doctor, would have cost us $5,820 + $25

1 year Of Premiums = $11,640.00

10 years = $116,400 to $150,000 (with yearly rate increases)

20 years = $300,000 to $400,000 (with yearly rate increases)



Catastrophic Coverage

Blue Cross Blue Shield of Texas

Hospitalization Only Insurance Plan

$10,000 Deductible (with Co-Ins)

Monthly payments (For John and Mary)

$325.00 a Month



10 Year Cost Comparison with a $40,000

Hospital Bill

• Option A- Comprehensive Health Insurance

• 10 years Premiums + $1,000 Deductible + $3,000 Co-ins for a

$40,000 Hospital Bill =

$154,000 (Approx.)



Same 10 Year Cost Comparison

Hi-Deductible Plan

• Option B - $10,000 Deductible Plan (Hospitalization)

• 10 years Premiums ($40,000)+ $10,000 Deductible + $3,000

Co-ins and the same $40,000 Hospital Bill =

$53,000



Section 125 Cafeteria Plans

Here, an employer-based system could beuseful, but not a system that tries to insureroutine health care. Instead, employers andemployees might be asked to put money intoindividual “Flexible Savings Accounts“ and/or“Health Re-imbursement Arrangements” for

employees.



AWIS Including Hospital Patient Advocacy

• Option C

AWIS and Catastrophic Insurance

Add a “Section 125” FSA and/or HRA to

offset the deductible for Employees



Conclusion

• Same $40,000 Hospital Bill

• Over a Ten Year Time Frame with premiums

Which would you prefer? • Option A---- $154,000 Total Cost

• Option B---- $53,000 Total Cost

• Option C---- AWIS & PAC and Option B



Sensible Options

• Use Catastrophic Hi-Deductible Major Insurance

Plans for the Big Medical Bills

• Use AWIS with plans around $119-$219 a month (for an entire Family) for the small Medical bills,

(Doctor visits, Blood or lab work, Prescription meds,

X-rays, MRI’s, Cat Scans, Dental Services, Eye-Glasses, etc..)



Example: AWIS Plan Cost $119-$219 a month for a Family:

$10,000 Accident, $10,000 Critical Illness, and more

• Catastrophic Insurance and an Awis plan would save you

anywhere from $250 to $700 a month.

• If put aside into a monthly savings account, it could grow from

$100,000 to over $200,000 over a 10 - 20 year time frame.

•

Do you want the Insurance company to keep this, or would you rather keep it in your bank account?

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Requirements for a Proposal

1. A company census of all employees, age,single, married, children, for a group quote

on a Hi-Deductible Major Medical Insurance

Plan within 3-5 business days.

2. An AWIS Plan will be added to help offset the

insurance deductible.

3. (Optional)- Set up a Section 125 plan. This

can be a FSA, HRA or both.



Thank You!

And Welcome To

American Workers Insurance Services!

Business Owner Major Medical Comparison 2

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