Who wins with today’s individual plans?

For brokers who have an HPA private exchange website, their success depends not on their ability to close a sale but rather on their ability to generate leads. That’s because their private exchange includes a toll-free number and a world-class call center staffed with licensed agents who take care of the individual sales for them. That frees up the agent’s time to focus on sending as much traffic as possible to the website.

But where do those leads come from? There are a million possibilities, and we’ve shared some of those ideas with you in the past. But during this year’s open enrollment period, it’s especially important to understand who benefits from the plans currently being offered in the individual market. Here are three groups you should be marketing to because they’re the ones who are most likely to sign up after examining their options.

1) People who qualify for a premium tax credit

Yes, the financial assistance available to people with incomes up to 400% of the federal poverty level is still the biggest selling point in the individual market, so you should continue to work to identify groups of low-income individuals who are ineligible for employer-sponsored coverage. Part-time employees and their family members meet these criteria, and employers shouldn’t mind letting  you talk with them since there are no employer penalties if these folks get a subsidy.

2) Young, healthy spouses

Employees who are eligible for group insurance benefit from the employer contribution toward the cost of their health coverage and are unlikely to find more affordable options in the individual market. Most employers, though, don’t contribute toward the cost of dependent coverage, so it’s possible for an employee’s spouse and children to do better with an individual plan. This is especially true for young, healthy spouses. Why? First, the individual market is age-rated while group plans are usually composite rated, so younger people tend to pay more for group coverage than individual coverage if they have to pay the full price. Second, younger individuals may be willing to purchase less coverage and accept restrictive provider networks (bronze-level HMO plans) if they can save some money versus a group plan.

Again, there’s no disadvantage for an employer to give you an opportunity to market to their employees’ spouses since there are no participation requirements for dependents and no financial penalties if spouses choose not to sign up for the group plan.

3) People whose doctors participate in the network

The problem with the smaller HMO networks that dominate the individual market in many parts of the country is that people don’t like changing their doctors. But people whose providers participate in one or more of these networks don’t have to change doctors. So, clearly, a great source of leads is the doctors who are on these plans. If you haven’t dropped by a few medical offices with cards that have the address of your private exchange website, what are you waiting for?

You don’t have to implement all of these ideas to be successful, and you may have more ideas of your own. The point is that there are a lot of opportunities during the last few weeks of open enrollment, especially if your main objective is to drive traffic to your private exchange website, so pick a strategy or two and then get out there and make some money!

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