Example 2: Enrolling with employee-paid Major Medical for a new organization. The company did not offer major medical benefits.

What to say:

A. BUILD RAPPORT

“Hi _____, my name is _______. I handle the benefits for _________.”

"As you probably heard from (your supervisor), you now have access to benefits! This is a new program (your boss) was able to bring for you. (He/she) cares about you guys and we agreed it'd be a positive step in building a future for the company."

“Now I know this may be a nice perk for you, but I also know it'd mean a lot to (your boss) if you sent a quick text saying thank you for the benefits. So be sure to tell (him/her) thank you!”

“My job is to show your options to you and explain how they work. You can choose one, two, all, or none of the plans. I’m here to help you find what might be a good fit for you.”

B. ASK QUESTIONS - BREAK THE ICE

"How long have you been with ____________?"

"Where are you from originally?"

“Do you have health insurance?”

>>>>>If they say "No, I don't have health insurance..."

- Federal law requires everyone to get health insurance or be subject to a tax penalty. In 2017, that penalty is 2.5%. This means if you earn $30,000, you'll pay $750.

- Don't worry. I'm not the IRS, and I'm not collecting the penalty. But I can run a quote on Covered CA, and I can get you enrolled once the exchange opens on November 1st.

(Go to www.coveredca.com. Under the "SHOP AND COMPARE" link, click 2017, and run an illustration by answering the basic questions.)

Note: We don't enroll Covered CA here on the job site. We will enroll you by phone after hours -- most likely after November 1st, because the open enrollment window may not allow us to enroll you until then unless you have a qualifying event. It will take about 30 minutes. Coverage will not begin until January 2018 unless you have a qualifying event.

• (Agent: Write down their hourly wage, and or annual salary information)
• (Agent: Take a photo of their Driver's License or official ID)

- As a single 30-year-old male earning $28,000 in zip code 90006, it looks like your lowest option on Covered CA is $150-200 per month. This is a bronze plan with a $6,250 deductible. This means that beyond your annual physicals, you will have to pay up to $6,250 out-of-pocket before you get coverage for most hospital and doctor visits.

Keep in mind, under ACA regulations, health insurance is considered affordable if it's 9.5% of your household income. That means if you're making $30,000 per year, it's considered affordable at $237.50 per month.

>>>>If they say "Yes, I already have health insurance..."

- Great! Do you understand how your plan works?
- Most Health Insurance plans today come with deductibles. Do you know what yours is?

- If you're on your parents' plan, it likely comes with what's called an "Out-of-Pocket Max." So understand there are out-of-pocket expenses (like deductibles and co-insurance) your parents have to pay if you use any medical services above and beyond your annual checkups.
- On a "Gold" or "Platinum" plan, this Out-of-Pocket Max can be up to $4,000 - $6,000.
- On a "Silver" or "Bronze" plan, this Out-of-Pocket Max can be up to $12,500.

This means that beyond annual physicals, you have to pay money out-of-pocket before you get full coverage for most hospital and doctor visits.

What's great about the Aflac Accident plan is that it helps to supplement out-of-pocket expenses related to treatments for accidental injury. This will seriously limit, if not prevent, you or your family having to pay anything if you visit a doctor or hospital. (Go over the plan).

ASK QUESTIONS - IDENTIFY AREAS OF CONCERN

"What would you say is your biggest concern when it comes to your health?"

"What is your biggest concern financially?"

"Do you feel like you understand the true cost of medical care?"

If the response is no, cite material about costs rising and income going down from the Group Presentation.

C. OFFER SOLUTIONS (SOUND LIKE A PRO)

It sounds like major medical on Covered CA was a little expensive at $200 per month. Just know that if you decline, you may be subject to a tax penalty of ~$695.

Beyond the financial stuff, with no health insurance, you expose yourself to risk against the enormous cost of medical bills. Now, since you're young, statistically speaking you're probably not going to get a critical illness tomorrow. But you might get into a car accident, or fall off a ladder, or twist an ankle. And the last thing you want to do is forego medical attention if you're injured.

If you don't have health insurance, the nest best thing to have is Accident Indemnity. This is a health protection plan. It pays for treatments related to accidental injury only. Some features include a $120 benefit toward an injury evaluation, $1,000 for a hospitalization, $200 for an ambulance ride, $200 for an MRI, and up to $1,250 for surgeries. It also contains an annual benefit for physicals after one year. The cost of this plan is about $31 per month.

Compare the costs:

Option 1. If you pay for major medical, you will pay a total of $2,400 for the year. This doesn't include your out-of-pocket costs, including your $6,300 deductible. If you have to actually use your insurance, you'll pay $2,400 + the first $6,300 of medical costs (or up to $8,700).

Option 2. If you forego major medical but get Accident Indemnity, you will pay only $380 for the year (for Accident Indemnity). You may be subject a $600 tax penalty, but you'll only be looking at a combined total ($380 + $600) of only $980 for the year.

I can't tell you not to elect in major medical. But this does show you the financial difference between the two options.

(Review all other options including Dental, Vision, Disability and Life. Explain how each plan works. Try to begin prioritizing.)

PRE-CLOSE

These benefits are deducted directly from your paycheck. 

All of these plans are portable. So if you leave the company, you can keep your insurance at the same rate. You’ll just convert it to a credit card or bank draft. Your Accident Plan is also pre-tax, so you’re saving a little money on the cost of the plan.

CLOSE WITH EASE (Advise! Counsel! Don't say "Any of these sound good to you?")

Based on what I’ve described, what plans would you say are the biggest priority to you?

None of this makes sense unless it’s affordable to you. Like we discussed, the national guidelines of 9.5% affordability was a little high for you!

In my experience, most people will try to keep it to about 1-2 hours’ worth of wages per week. (So if you make $12 per hour, you shouldn’t spend more than $18-20 per week, or $40 per biweekly paycheck.)

Do you have an amount in mind that you’d like to keep it to?

Let’s find a way to do that. Can I run a quote for you?

FINALIZE
- Run the quote
- Get the yes
- Complete the app quickly. Get signatures on app and Premium Deduction Authorization (PDA)
- Provide brochures- Provide a copy of the PDA if doing paper or Everwell
- Explain when premiums will begun deducting
- Provide a "Welcome to Everwell" sheet with information about filing claims
- If SNG only, write down the premium deduction amounts on the Welcome sheet
- Provide Claim Forms for Vision or Dental

*****Don't forget to say:
For the plans you chose at pre-tax, keep in mind you are locking in to your coverage elections until next year's open enrollment, or you leave your job, or have a "qualifying life event" like getting married or having a child.

COMMON OBJECTIONS:

1. Money's tight!

This means you didn't customize a plan based on their budget. You should not sell products. You are customizing a plan package.

What to say: "Money may look tight now, but it'll be incredibly tighter if you ever get hurt or sick. You'll find that having even base coverage will help if you actually have to use any health services. Remember, if you never have to use this, it's a small financial mistake. But if you need it but don't have it, it's a huge financial mistake."

2. Why do I need this if I have health insurance?

This means you didn't properly educate the state of health insurance plans, and how deductibles and out-of-pocket costs will bankrupt an individual. 

What to say: "If you get hurt or sick, your costs will go up, even if you have health insurance. Aflac plans exist entirely to offset the enormous costs you aren't even aware of, like having to hire someone to bathe you if you have a broken back. Even a base plan will help you. The Accident Plan will pay for something as small as a cat bite."

 3. I'm on the fence. I don't want to lock in for a year.

What to say: "I understand. And I wouldn't be telling you it's worth it if I didn't believe in it. But don't take my word for it. I want to show you how this plan is worth it. Good news is, if you get the plan after-tax, you can cancel at any time. You won't be getting the tax-savings, but you can try it out and see if what I'm telling you is actually true!"