Join URL's Group Health and Medicare gurus to discuss the importance of educating the Group Health market on the timing of Medicare enrollment and how to lower your group rates by offering Medicare benefits for those eligible. Listen as our experts share useful strategies and marketing ideas to help you grow your business in 2023.
Christy Wilbert: Hello everyone and welcome to our webinar today, which is Group Health to Medicare Marketing. I am Christy Wilbert, vice president of Medicare offerings here at URL Insurance Group, and I'm gonna be your host today. I brought along with me two familiar faces, at least they should be one.
You should see Thomas Purcell. He handles all of our group health referrals from our agent partners. He'll share a lot of his real life experience with you today and some selling techniques. And then we have Elyse Fry. She manages all the agent support side of things for the group health for all of our agents. So she is gonna share her expertise on some of the tricky things that come up often when we have people transitioning from group health to Medicare.
So our goal for today is to inform you on the benefits of encouraging Medicare eligibles to come off of the Group Health plan. How to incorporate that into your sales presentations and educate you on a few of the ins and outs that often arise when that occurs. And also provide you some marketing information and ideas.
Before we get started, in case there's anybody here with us today that does not work with URL currently, I just wanted to take a moment and explain the benefits of working with URL. Here you're gonna see our logo, which does represent a heart of three sections, which is you, your clients, and us here at URL.
It just reminds us that at the end of the day, our passion and our purpose in the industry is to make sure you and your clients feel better, safe and protected by the products and services that we provide. Our slogan is that we're in the people business because the people here and our relationship building is really makes us special.
Hopefully we get some good questions that we can answer for you. And the handouts that we'll be referencing are there for you to download as well. But the poll is what line of business do you focus on?
Christy Wilbert: So we're curious, out of everybody that's on here today, what do you focus on? Do you focus on Medicare? Do you focus on group health insurance? Are you actively cross-selling both and you're just here for maybe some marketing ideas. Do you wanna learn more about how to cross sell into these markets and that's why you're here today?
So majority so far is group health. I'm just gonna keep that up for one more moment and we're gonna go on to our next slide and have Thomas start us out with some group health basics.
Thomas Purcell: Thanks Christy, and good morning everyone. Group Health Benefits, just to give you a really high overview of the fundamentals of the basic group benefits. The plans, typically there's an employer employee contribution arrangement. Both the employer and the employee have to have some skin in the game when it comes to who's paying for premiums.
And typically both are going to contribute a portion of that. Generally speaking, most of the plans are going to have high deductibles. There's a lot of HSA qualified plans that have higher deductible options as well. There's the traditional PPO HMO type plans that have copays for those everyday type procedures such as, you know, primary care visits, prescriptions, urgent care complex imaging, things like that.
So with those group health benefits, there are huge benefits to the employer and to the employee for the seniors coming off the group. That's why we're here today. With Medicare, the employer will pay less. The employee will pay less in most cases, unless you have a circumstance where the employer's paying a hundred percent of the benefits, which we still do see sometimes, but not often.
Usually there's like a 50/50 contribution or howeverthe group is set up, but possible lower monthly premium. Lower deductible, which is usually a hundred percent of the time. Medicare doesn't have deductibles, no matter if you're on a med sub or a Medicare advantage plan. And then lower co-payments.
Christy Wilbert: So we do have a little example here to show you, which I think seeing the numbers, raw, like that will be very helpful. Just to go back to our poll that I put out earlier. It looks like a huge percentage of you are doing groups. Thank you so much for joining us today and it looks like you wanna learn more about cross-selling, so I hope this is very helpful for you.
What you're seeing there in the first column for the group health comparison is what a normal person that's maybe 65 would cost in full. This is the employer and the employee contribution. And as I said earlier, they could be doing a split. So let's just assume the employer's paying $500 a month or maybe even more.
Maybe the employer's paying $800 towards this person a month and the employee's picking up, you know, $400 of it. You get $200 each paycheck for that plan. So you can see how that would be a huge cost saving to the employer and to the employee. Neither are contributing if they come off of the group Health plan.
The alternative would be a Medicare supplement or a Medicare Advantage plan, which most Medicare advantage plans now are $0. You can get a great $0 PPO. I'm not gonna go into details about Medicare, that's not the purpose of today. But definitely call me if you want more information.
Christy Wilbert: A Medicare supplement where you can go anywhere. There's no networks with a Medicare supplement. Pay in the beginning of the month. Anything you have is covered except for your Part B deductible, which is an annual deductible, which is the $226. So as you can see, your deductible is $226 on a med sub as compared to maybe a $2,000 deductible on the group health plan.
If you're the employee paying $200 a paycheck, again, this is just an example. You are now just paying a hundred dollars a month, so you're saving $300 a month on a med sub. You have no networks, you don't have anything to worry about there, and a lot of them offer wellness programs. So you're still gonna have maybe a vision and dental discount.
You're still gonna get your blue 365. We all know who we're talking about there. On the Medicare Advantage side, again, that's $0, so you have no monthly payment. So if you are paying that $400 a month on Group Health, it's nothing. It's gonna cost you nothing every month. There's no deductible on the Medicare Advantage side. There is sometimes on your prescription plan, but again, we can get into those details another time.
Wellness is always included in Medicare Advantage, so you're talking dental, vision, hearing, gym membership. It's the MacDaddy of plans, everything that they can possibly throw in those. Some even have over the counter cards now where you can buy things from pharmacies online, through catalogs and all kinds of good stuff.
And there are networks just as there are with group health. Many of them now are nationwide, so you don't run into any issues as long as you have the PPO plans. So that's just a little example of why we're talking about what we are today, because it is a huge cost savings for everybody. And if you're not talking about it, you're really doing everybody a disservice because it just adds trust with your group health HR person or owner of the business that you're working with. If you're informing them on all the ways that they could be saving money and helping the employees.
So a huge question that we all get. Thomas sees it, Elyse sees it, I see it is how can the employer, if they're now saving, let's just go back to that example, $800 a month, how can they still help the employee? You're not allowed to encourage it, but we can educate, right? We can educate the employee, how they're gonna be saving money to go on Medicare.
The big question is, can I pay for it? If I'm the employer, now that I'm saving that $800, can I somehow give it to the employee? Can I put it into their payroll? Can I pay it under the table? Can I, I don't know. We get the crazy questions. The answer is no, they cannot. There is one compliant way to do it, and that's to set up a Section 105, which is a health reimbursement arrangement plan, and that is something that the employee sets up in writing. And puts into account. You can either do it on a monthly basis or an annual basis, and as the employee pays their premiums, they can submit their receipts for reimbursement. So there's a ton of ways to do that. That's an FSA, that's an HRA. The negative to that is there is some admin that has to be done there.
But again, you're still saving money, so you can outsource the admin or you can do it in house depending on the size of your business.
Thomas Purcell: Christy. Yeah, if I could just add there that's a great point with this section 105 plan, and in terms of the strategy, you know, from an agent perspective or from an employer perspective, let's go back to that example you've been using.
An employer could save $800 a month and that 65 year old employee's age banded rate. If an employer, you're correct in saying, with an HRA arrangement, a section 105 plan, there's gonna be some small admin fees. If they were to outsource it, we have solutions there that I'd be happy to talk about and more than one, depending on the specific circumstance of the group.
If the employer's saving $800 a month in premium. They could still contribute that $226 a month towards the employee's Medicare deductible. And admin fees and still be netting well over half a thousand dollars a month in premiums that they could be using towards other benefits. So it's a really, a solid way to move an employee to most of the time, a better plan. Save the employer money, and like you said, make it a better experience for the employees. So this arrangement is a very popular and compliant way to have a win for the employer and employee.
Christy Wilbert: Thank you Thomas. Yeah, and obviously there are a lot of benefits to the section 105 as well. You know, the cost savings for the employer is an obvious one, because they have control over the allowance. They set that amount that they're gonna contribute. It's not willy-nilly, so that is easy to to budget.
And then the tax advantages. So they don't have to pay tax on any of the reimbursed expenses, which is great.
If you're comparing that employee situation where they're on that group plan, regardless of if it's a qualified plan or a PPO arrangement. They're gonna have copays or out huge out of pocket expenses in most cases, regardless of if it's a copay or a deductible.
Thomas Purcell: And with that section 105 plan, the employer can use their money to make more of an impact on the employee. Before we're just contributing to premiums and that employee still has huge out-of-pocket exposure, well let's make that dollar mean more to the employee instead of trying to contribute it towards the premiums. We can reallocate that money towards dollars that they can use for out of pocket medical expenses, which is huge.
Christy Wilbert: Thank you, Thomas. Okay, we're gonna move on to health savings account because this is a huge one. Obviously there are a lot of benefits to owning an HSA, even at our age because you contribute to it tax free out of your payroll.
It kind of works like a savings account. You're putting money in. It's tax free, it's building interest. There's no tax on that interest. Then you actually have the opportunity to move it to mutual fund if you don't spend it all. So it is a huge way to save money in a better way than saving it at a bank, because at a bank, everything's taxed.
A health savings account can be built really large over a long career. So people get very scared at the end of it, of how does it end? How is it gonna work.Before you approach 65, 6 months prior to, you have to stop contributing if you plan to go on to Medicare. If you do continue to contribute once you're enrolled on Medicare and now that's A or B.
Christy Wilbert: So at 65, a lot of people get automatically enrolled into Medicare and they'll get a card in the mail that says Part B effective date. Or part A, I'm sorry. Part A is always first because it's typically free if you've worked for 10 years.You actually have to check that I want to disenroll on that card and mail it back to Social Security if you plan to continue to contribute to your HSA.
If you don't do that, you will be tax penalized for any money that you continue to contribute past those times that you're enrolled in Medicare. So dis-enroll if you're gonna continue to work and be on the group health plan. So you can contribute. If you want to go onto Medicare, just stop contributing, go on Medicare and everything's fine. Can you use the HSA money to pay for Medicare? Yes, absolutely. That is your money. It is made for health. Any health reimbursement benefits you can use this for. You can use it for premiums, co-payments, deductibles, all kinds of things.
And again, once you turn 65, that money is actually available to you to take out for anything, not just health related service. Just know that you will be taxed on it when you take it out for anything that's not health related.
Thomas Purcell: Just something else to add there, Christy. I know we have a lot of group health agents on the webinar today. With the HSAs, if it's being offered on a group chassis where the employer's offering an HSA qualified plan and employees have that catch up contribution if you're all aware. Where they're an employee, 55 or older can contribute an extra thousand dollars over the typical contribution max limits for an HSA qualified plan.
Again going back to Christy's point on kind of stockpiling an account with funds for future medical expenses. This is the way to do that for sure. I'm a huge fan of HSA qualified plans. I could talk on a webinar all day about HSAs, but I'll save that for another one.
Elyse Frey: Thanks Thomas. Also, just as a reminder, the 2023 annual limit for individuals is $3850 for their HSA account and $7,750 for family. So that would be anything outside of a single husband, wife, parent child. They categorize that as a family coverage. Hi everybody. My computer stopped working by the way, so that's why I'm here as Christy.
So I'm gonna go over the primary and secondary coverages, and why it matters on the group size. So if you are under 20 in your group size, your Medicare is primary. So when you do get that part A card in the mail and you wanna defer part B. There is a possibility for penalties if you defer it past eight months.
So if you go longer than the eight month period, just know that.Medicare is primary group insurance would be secondary. If you are a group that's over 20, your group is primary. So when you get that part A if it's an HSA, you wanna defer it if you would like all that. But if you don't, there's no penalty for deferring your part B.
For a federal cobra sized group, that's over 20, the group's primary. So that's why it matters when you're considering dropping coverages in what you're deferring or not deferring. You need to know what group size and what category you are in, because nobody wants to save a bunch of money, but then pay a bunch of penalties.
So with that, there's also Cobra that comes into place. The length of time when it's over 20 and group is primary, that's federal cobra and that is 18 months of a continuation of cobra. A continuation of your group plan, if you were to drop your group insurance for really any reason to go on Medicare, to retire, anything.
If it is under 20, it's mini Cobra, which is only nine months. So it's much shorter amount of time and employers can charge up to 5% for admin fees and 2% for federal cobra. So again, any questions, just let me know. Primary, secondary, Cobra, all those things are quite complicated, so I understand if nobody got anything that I just said.
I have flyers available in the resources or the handouts. You can always just call me or email me and I'm happy to send you whatever you need.
To continue on Cobra a little bit and the options for your spouse. So say I'm working and my husband does not work, and he's at home and I'm going to retire. He's on my group plan. So what options do we have. We have continuation of benefits, which is Cobra. My spouse is eligible for those. Any person that is currently enrolled on your plan for your group coverage is eligible for these Cobra benefits. It gives you a qualifying event for Cobra, gives you a qualifying event for Penny, or you could get subsidies since you're no longer working, depending on your income.
Those are really kind of the options. But again, if you're not sure, give me a call, run it by me. I can go over, what options you have to move forward with.
Elyse Frey: Can they use social security for Medicare? This is Christy's portion. See ya.
Thomas Purcell: Tag team.
Christy Wilbert: Yes you can. People are eligible for Medicare, obviously same thing as Cobra and Penny. It gives you a special election period to enroll into Medicare. The question is the spouse thing, because that can get tricky. So if you are the worker, so I'm the worker and my spouse is younger than me and I turn 65 and come off the group. Obviously my spouse isn't 65 yet, so they don't get Medicare, so they only have the Cobra and Penny options.
If they're older than me, I have to be at least 62 years old, but my spouse that is not working is 65, so technically they would be eligible for Medicare because they're 65. However, they're not working, so they've never contributed to all the things that they needed too. Social security, to get premium free Medicare.
So this is where the spouse that's not working can actually use the working spouse's social security benefit and get premium free Medicare for A. They'll just have to pay for B, which everybody pays for B. So that's just something a lot of people don't know about.
Thomas Purcell: Thanks christy. When we were doing our walkthrough the other day, this was a gem of knowledge that Christy dropped on me that I wasn't aware of. This is a really powerful slide for me and it should be for everyone on the call because this is a great way to get in the door with groups.
You know, if you're a group health agent, you're used to looking at those group censuses as soon as you determine that there's a Medicare qualified and eligible on that census, that should be a red flag. I can give you a real life example. Of how this slide played into my everyday life.
We had a client, we were working with, a group that got referred to us and they had 10 employees, two of which were over the age of 65. One of those 65 year old employees had a spouse that was only 59. Come to find out, once we're consulting with the group and really getting to know what their needs and wants and pain points are. We determined that that employee was actually only working because he needed health insurance for his spouse.
He didn't even want to be working anymore. They didn't need the money. They needed the benefits. So that employee was paying well over $600 a month in premium. The employer was paying over $800 a month in premium. The plan was about $1,400 a month in total premium, just for him, not even including his spouse.
Thomas Purcell: So what we were able to do is say, "Hey, look, these group health insurance rates are crazy and they're going up every year. If we are, able to educate your employee on the benefits, the pros and cons of the Medicare versus the group plan. We were able to show that employee we could save him well over $10,000 a year and still get his wife a health insurance plan.
When we moved him to Medicare, his wife was no longer eligible to be on that group Health Plan as a spouse. She didn't work full-time, so she didn't have benefits available through her employer. So that gave her a qualifying event to then go to Penny, and collect a huge subsidy on Penny. She's still getting the same level of services with her health plan on a penny plan versus the group health plan, but paying a fraction of the cost. Now that employee is going to Medicare where he's saving out-of-pocket costs and huge premium. The employer is ecstatic because he just moved two employees and a dependent from his group health plan to Medicare. They were extremely happy about it.
So that's a real life example, of a win, win win. I'm just coming across it more and more where you have these employees that are Medicare eligible 65 or older, and they have spouses that aren't. They're just working a couple more years longer than they might want to, because they need a solution for their spouse.
My parents were in the same situation. My dad is eight years older than my mom. He'd probably be upset if I told everyone this, but you know, he's eight years older. If you ask them, he probably worked a year longer than he really wanted to. Just because they were trying to determine what they would do for the next eight years for my mom for her health insurance because she wasn't Medicare eligible. She was self-employed, so she doesn't have insurance through her employer.
Thomas Purcell: So, yeah, powerful slide here, Christy. Thank you.
Christy Wilbert: Of course. I think another, great thing to mention is that typically the employer, the owner of the business is 65 plus. They don't know how much they're paying for their own health insurance that they could be saving on a Medicare plan. So I think that's always funny.
Let's end with some marketing ideas. A huge thing you always want to be thinking about is referring. Referring business back and forth, right? How can you help your client get more clients? And how can your client help you get more clients, you know, scratch each other's back.
Christy Wilbert: Always have the conversation of how to help each other grow one another's businesses. Create that referral source because everything in life and in business is relationships. It is word of mouth, and it is having healthy relationships with everybody you do business with. Somehow the world always seems really small, and we all have connections, right?
If you are the Medicare agent and you don't do group health, obviously go into places of employment and offer to do Medicare presentations. To educate those employees about Medicare and how it would save them money to come off. I think there's always just fear surrounding Medicare, because they don't understand it.
They've never experienced Medicare before. They have a lot of questions. So if they have somebody to guide them off of the group, they're more likely to do so. If you are a group health agent and you work with the group, offer to do the same thing to go in and do Medicare presentations. Or bring a Medicare agent in that you can partner with to have them do Medicare presentations.
Christy Wilbert: Offer to do a customer educational meeting. So if you work with a diner and they have a back room offer to put something on their bulletin board. Make sure that you're having, maybe it's an annual checkup with your group health relationship. That you're looking around at opportunities to make sure you're co-marketing or you're matching their vibe with the business.
If they have a bulletin board, you better be on that bulletin board. If it's a pizza shop and they have all the kids from the high school teams all over the wall and all businesses make sure your business is up there. If they're handing out anything for free, make sure that your logo is on that item.
If it's a bar and they're using coasters that are toss away, why is it not your coaster? If it's a pizza shop and they're using paper cups, why is it not your logo on that paper cup? It's not gonna cost you a lot of money to buy paper cups for a pizza shop. Making sure that your front and center of everybody that you do business with and touching every single one of their customers and clients.
I mentioned signage at the brick and mortar, and that's more than your relationships with your group. A little town like here, we have Lingos Town and it's a little circle and there's little shops that people walk up and down all the time. Especially on the weekends.
Christy Wilbert: Why not get something on one or two of those windows? Beautiful sight line to the road. Everybody's driving by. It's walkability. So if you have a cute little town like that, and you have relationships with the people and those business owners. Make sure you're getting your information up and out there for them all to see.
So if anybody wants to talk more about marketing, I'm happy to do so. As you can see, I'm very passionate about it and my ideas are always grand.
Thomas Purcell: Yeah, I just wanted to touch on that referral bullet point, Christy. Whether that's referring the business to URL or another group health agent or a Medicare specialist.
You're providing tremendous value. And, and that's a differentiator nowadays. There's a lot of group health agents that don't specialize or refer out Medicare currently. And if you start doing that, that is a huge way to differentiate yourself. If you're playing in the large group space, you're gonna come across censuses that have quite a bit of Medicare eligible individuals. That's opportunity just being missed out on if you're not at least having that conversation with the employer or partnering with someone that can have that conversation with the employer.
Outside of generating new revenue for your agency, which is also huge. Anyone that gets into Group Health, I tell 'em they need to get into Medicare too. Outside of the revenue, I mean, you're creating tremendous value with your clients and that referral relationship. If you don't want to be specializing in those products in-house, obviously you can outsource that to URL. We can be your partner there, but there's other agents out there that can help you with that. If you're not taking advantage of it, you're missing out on tremendous opportunity.
Christy Wilbert: Thank you, thomas. So we do have our Medicare Connections Conference already set this year.
It is for August 24th, which is a Thursday at the Hershey Lodge. We'll have a bunch of our carrier partners there. It's not just a Medicare conference anymore. We usually do have penny there. Social. Security is usually there. And all of our carriers, as you know, do group health. They do the ACA, they do the Medicare.
So really you can ask any questions about any line of health insurance business that you'd like to, and not just health insurance. We do have some life and annuity carriers. Some marketing and lead vendors that are gonna be there as well. So I hope you can join us, save the date now, and we look forward to seeing you there.
All right, and if you have any questions, you can contact Thomas, Elyse or I here at URL. I'll see you at our next webinar, which I think is next week. If you're following along, we have Aetna Ancillary Products being discussed next week. If you've missed any of our webinars before, you can go back on our training calendar and re-watch them at your convenience on demand.
They're all recorded as well as this one. Okay, bye-bye. Thank you.
Thomas Purcell: Thanks everyone.