00:24 — Introductions

05:24 — Who is Optimly Benefits

08:22 — What makes Optimyl unique

14:06 — Optimyl’s reduces cost through attacking inefficiencies

19:12 — RX Rebates

21:20 — Network Options

23:55 — Referenced Based Pricing Flavors

26:02 — Product Catalogue

29:30 — Program Options

31:12 — Stop Loss Options

32:26 — Requirements for a Preliminary Proposal

36:33 — Broker Compensation

37:10 — What states are we in?

37:58 — Long Term Advantages for using Optimyl

Jason Powers:

It is time for another carrier product update. Tune in as we talk directly to the carriers about their new plans, any new network options they have, or which plan designs offer the most savings and learn about the tools and resources they offer to help you generate more business. Visit our website to learn about all of the carriers we quote in our carrier product update series.

Hello and welcome back to our carrier product update series, a very special episode of our carrier product update. This is [00:00:30] our Q four kickoff summit for 2023 with new business in the Q one of 2024. I’m Jason Powers joined by Brad Williams from Optimal Benefits. Welcome to Lenexa. Welcome to the studio. Welcome to Legacy. Thank you

Brad Williams:

James. It’s great to be here.

Jason Powers:

Yeah, and I got to say that we’re really excited to have you here, not just having you here, but having optimal on our series and having optimal in the Legacy Broker’s portfolio. So we [00:01:00] appreciate the persistency, if you will, of trying to get me tied down to look at things that Optimal is doing. We’ve spent the last probably 6, 7, 8 months talking back and forth trying to pin down some times, reviewing documents, vetting out sort of what the product is. And so this is our launch of optimal benefits to our brokers [00:01:30] out in the community. If you’ve not seen optimal or not seeing the millions of emails that they sent out to agents across the country, don’t worry. We did see them and we took the initiative to learn a little bit more about the product. Have had some meetings with you and your team to get more comfortable with what it is we’re going to be talking to our brokers about and really excited to launch. So we are officially a general agent [00:02:00] with Optimal benefits, which is a new thing for us. Not new in our business model, but a new relationship for us, which means that the Producer commission and the production credit goes to you, the producer, for anything that Optimal is doing. So I’ve spent the time talking to you and learning about Optimal. I’ve talked to our team about Optimal. I’ve talked to a few brokers about Optimal already, but what could you describe, what would you describe optimal as or describe [00:02:30] Optimals position in the market, if you will?

Brad Williams:

I’d brokers’ be happy to. Yeah, so I look at us, and it’s a word I don’t use too often in insurance, the word refreshing. You can use the word refreshing in a hot day and you mow the lawn and you want to Arnold Palmer. That’s refreshing. But the feedback that we’re getting back from the marketplace is this is truly refreshing. The level of innovation and creativity that we’re bringing, I’ll share that we are targeting small and medium sized employers. The reason why is we all [00:03:00] realize the healthcare system is broken, but it’s really broken for small and medium sized companies. And so what we’re doing is focusing on companies from two to 300 employees providing a solution that is really groundbreaking and it truly is quite refreshing within that two to 300 size range. I would say that our bread and butter, our sweet spot is going to be the groups that are between two and 50 enrolled employees.

Jason Powers:

And that’s a big void, I think to fill. [00:03:30] Yes, we’ve had a lot of people on today that have products in that segment and those products have existed in that segment for some time. But this is something new. This is a new product. There’s a lot of stuff that you guys have packed into your product that is not available in some of those other products in the market. And from what we’ve seen so far competitive price point, it looks like you’ve got a carrier [00:04:00] behind it that is ready to write some business in that segment. So we’re excited to get started.

Brad Williams:

Fantastic. Yeah, we are too. We’re chomping the bit,

Jason Powers:

So not a carrier update, but let’s talk a little bit more about you. I know you brought a little side deck to talk to brokers about. I’ll let you guide us through here.

Brad Williams:

Oh, well thank you, Jason. So it’s no secret that our healthcare system is broken. We’ve heard words from Warren Buffett that it’s the tapeworm of our economy. [00:04:30] We’ve seen a huge increase in the percentage of our G D P from 5% to 20%. And that impact has hit employers, especially small businesses. They’ve seen increasing spikes in their premiums with leaner, leaner benefit plans. So they’re paying more for less and it’s really impacted the middle class. It’s really hitting their income, their disposable income. And so there has to be a solution. If we did do something [00:05:00] now as a country, we’re going to be in trouble. And that’s where Optimal is coming in. That’s the position that we’re taking as we are going to take each group on a singular basis, make an impact, create a customized solution that meets their benefit needs objectives, and just go from group to group.

And we’re so excited to be partnering with Legacy Brokers and doing that. Our mantra is basically we’re an M G U and a program manager, M G U for managing general underwriter. [00:05:30] We do all of our underwriting in-house regardless of the size, and we have a spectacular underwriting team, so excited about the underwriters and the support that they provide in the marketplace, but we’ve integrated with some of the most trusted brands in the marketplace. First of all, our third party administrator is Allied Benefit Systems out of Chicago, the largest and the last of the largest independent TPAs in the country in providing administration services [00:06:00] to small and medium-sized companies. When you look at our stop-loss carrier, it doesn’t get better than North River Insurance Company, a K a Reman Forster. They’ve been around since 1822, over 200 years of strength and stability A rated. They provide the stop-loss and we’re actually their first foray into small group level funding below a hundred employees. And then from a network standpoint, I mean Cigna, we use their Open Access plus network, their [00:06:30] P P O network, and in areas where they do have the local plus, we can also provide that as a network solution. And it is priced very competitively for groups that are above 51 plus enrolled employees. We can also look at the Aetna Signature Network a S A network as an option for those types of employers.

Jason Powers:

And you couple that with a difference in PBMs, right? If we go under 50, we’re using Cigna’s [00:07:00] P B M on the under 50 market, and then 51 plus we have the option, I think. Is that right with Aetna to use the C V SS Pharmacy Benefit Manager or

Brad Williams:

Almost, yeah.

Jason Powers:

Am I coming close? You’re close. You’re

Brad Williams:

Close. So the P B M will coincide with the carrier. So if it’s a Cigna network, it’ll be the Cigna P B M, and then if it’s an Aetna network, it’ll be the C V SS Caremark net P.

Jason Powers:

Got it. And I think some brokers might be familiar with Allied benefits systems with some other products [00:07:30] that are out there. This is not that same product. This is potentially the same administrator with some of the same look and design, but certainly a different product on the backend.

Brad Williams:

That’s correct, yeah. And let’s go into more detail about these brands and these partnerships that we have within the program. Along with the Cigna and the Aetna P P O plans, we’ve also brought a very refreshing [00:08:00] reference-based pricing solution that is there to help employers just gain a little bit extra control on their healthcare claims cost, and it can be a very effective alternative for brokers in the marketplace.

Jason Powers:

That’s great. Let’s see here. Yeah, we’ll do questions at the end there, Bob. Thanks though.

Brad Williams:

What makes us unique? Well, we are the newest freshest healthcare technology company in the marketplace. Our [00:08:30] technology is definitely at the tops in terms of superiority. We have our own benefit administration system that helps with ads, delete terminations for the health plans. We can also come at the marketplace from a position of we are tech agnostic, so we can work with any type of benefit administration system in the marketplace. We can also work with third party services such as Form Fire, [00:09:00] easy App, and Ease as well when it comes to IQs.

Jason Powers:

That’s great. So they can bring whatever system they’re using, you’ll work with those systems. And does that go for the eligibility piece too? So the adding and taking off of people, we’ve got electronic access on that side of things?

Brad Williams:

That’s a great question. The thing that separates us from other platforms out there, [00:09:30] we do all the eligibility in house, and so all of the eligibility will be handled by optimal and not an outside resource.

Jason Powers:

That’s great because you’re the M G U and the program manager. Exactly. Things that’s important. It is.

Brad Williams:

It is. And we have various shopping tools as well that helps the employees be able to identify who are the high quality cost effective providers in the marketplace. And it’s just been amazing that [00:10:00] there really hasn’t been a true resource to give employees the ability to see what is the cost of that provider in their region. And so we’re able to do is show that employee based on their diagnosis with the full cost or the episode of care, it’s going to be for that employee. We can get as granular as showing them what’s left, their deductible and their co-insurance responsibilities. So it brings the full transparencies that employers need to offer relative [00:10:30] to the Tick rule to make them compliant.

Jason Powers:

And this is power of transparency in the palm of the member’s hand. I’ve seen the demo on this from the company that you guys have deployed in this product. It’s incredible. I mean, it’s truly incredible. Then the flexibility of building incentives around that shopping tool and giving that power back to the member. [00:11:00] I think back to 2004 ish, 2003, 2004, when HSAs first came around and high deductible health plans were out there, brokers, if you’ve been out there selling HSAs over the last 20 years where I’m going with this, we told the consumers out in the healthcare space that they’ve got to be better consumers, they’ve got to be smarter consumers, they’ve got to make more informed decisions about their care. But we didn’t [00:11:30] give them any way to do that other than penalizing. Right. Well, you’ll find out when you get the bill, right? Yes. And this puts everything in the palm of their hands so that they can be wiser consumers. I think having these kinds of tools will certainly reinvigorate, I think a lot of interest in the health savings accounts and the high deductible plans again. Oh,

Brad Williams:

Absolutely. And we’re excited to offer that. And for those members that are in a P P O plan, I mean [00:12:00] there’s various opportunities for them to gain cash rewards. We’re making the wise decisions and we know wise decisions can impact that renewal adjustment.

Jason Powers:

Yeah. And couple that with R B P. Maybe not on the incentive side, but just the knowledge and transparency. Wow. Yes.

Brad Williams:

Good stuff. Huge.

Jason Powers:

Again, that’s what we were excited about it. We need to come back to slide Bob. Yeah. So you covered shopping tools. [00:12:30] We talked about network a little bit. Want to cover R B P a little bit more?

Brad Williams:

Yeah, the R B P solution that we can bring the table. It’s just another way for an employer to evaluate what is a potential solution that could be a better fit for their group health plan and choices when design right can be very powerful for employers. And so being able to give that company of five employees another option that may better benefit their [00:13:00] needs from a monetary standpoint as well as a plan design standpoint can be very impactful for them. And it just comes down to give them ways to better control their healthcare cost.

Jason Powers:

And this is all, again, down to two lives,

Brad Williams:

Down to two lives, down to two lives.

Jason Powers:

That’s fantastic.

Brad Williams:

And I’ll say too, in terms of our broker support, we’re going to have a team of account managers that once the group is sold, we’ll be there to support their brokers and their customers [00:13:30] and their clients regarding any type of service issues, claims issues. The account management team will also be involved in the renewal process. And so when we say that we will provide white glove support, you’ve heard that said before, we truly do focus on doing that as a differentiator in the marketplace with our competition.

Jason Powers:

Alright, next slide. You got a lot of stuff up there to talk about.

Brad Williams:

We’ve got [00:14:00] a lot of stuff, so this is going to get a little more granular if I may, but when we look at how optimal is uniquely positioned to really attack the inefficiencies that we see in our healthcare system to reduce costs, we look at really four types of boxes. We look at cross provider price variance, we look at specialty drugs, we look at the cross payer provider subsidization as well as pharmacy rebates. And we know those are four big areas that encompass our [00:14:30] healthcare plans. And so we address all four. The price variance is really truly unbelievable that within networks you can see a big disparity between provider A and provider B. And so that’s one of the things that we’re doing with our transparency tool is just helping to give the opportunity for that member, that employee to better educate themselves on who are the providers that are out there, not just from a cost standpoint, [00:15:00] but from a quality standpoint. And when they can meet those quality metrics, they’re going to get a high ranking. And it’s nice because it’s a very simple coding system. It’s green, yellow, and red. And green means good, green means go. So it’s that simple for the employee and the member to be able to gauge who are the higher quality providers that they can utilize to meet their service needs.

Jason Powers:

Again, I’ve seen that tool. It’s incredible [00:15:30] the power of the information that’s embedded in that tool and being able to have that in the palm of the hands of the members gives them incentive, gives them buy-in to all the things we’ve been talking about in this space for 20 years. Oh,

Brad Williams:

It does. And it’s all on an app. It’s right there in the palm of their hands through their phones and it’s easy to navigate to. So it’s a well-planned, well implemented transparency [00:16:00] solution. It’s fun being able to work with optimal because we are truly a healthcare technology company and our technology has unsurpassed.

Jason Powers:

Love it. All right, so what do we got here?

Brad Williams:

So let’s go to the next slide.

So there we go. So this is where we look at some more inefficiencies. The providers [00:16:30] when they are looking at commercial versus Medicare, there’s a much higher profit margin on the commercial group health insurance side because they get to make up for a lot of the discounts that they take off their bill charges for Medicare. And those pricing levels can be exorbitant sometimes. And so that’s one of the things that we’re looking at with our reference-based pricing solution is just coming in and being kind of an equalizer to [00:17:00] help the employers be able to provide a service. But it’s good for both the provider, the member, and the employer. And I think that’s the biggest takeaway with reference-based pricing.

Jason Powers:

I agree.

Brad Williams:

Especially drugs. Especially drugs. Man, I tell you what, that’s becoming a big topic in our marketplace right now.

Jason Powers:

Most every case we’re working on right now has got at least one of them.

Brad Williams:

Exactly. And so what we’ve done is we’ve created some [00:17:30] solutions that will allow the member to be able to obtain some specialty drugs at a reasonable price where they’re well taken care of, but also will help the employer be in a position to be able to manage their renewal adjustments on an annual basis. And again, it’s a win-win for the member as well as the employer.

Jason Powers:

Yeah. Again, this is something that we see almost every case we’re looking at [00:18:00] has this train wreck.

Brad Williams:

That’s a great way to look at it. Jason,

Jason Powers:

A train wreck. Yes, everything else in the group looks great, but there’s one drug that’s costing the plan six to $7,000 a month and is an obstacle or a barrier to finding a competitive renewal alternative. And so plans that don’t have any kind of mechanism in place to take care of these in a different [00:18:30] way, they’re a challenge. And so optimals got a great solution for it. We’re excited about it and ready to get that worked into our Q four quoting.

Brad Williams:

We’re excited too. And I’ll also share that we’ve seen cases come in where a mainstream level funded company or solution would decline to quote, and we’re able to come in with our robust solutions innovation and provide a solid solution that’s really going [00:19:00] to help that employer reduce their healthcare cost and be in that position to stabilize their premiums on a go forward basis.

Jason Powers:

Yeah. Rebates. There’s another one. The rebates. It’s like the Lego I step on in the middle of the night, right? Prescription rebates. It

Brad Williams:

Is. It is. And with that, the pain doesn’t go away when you step on the Lego. It’s a short term situation, but we were [00:19:30] able to get a unique glimpse in the inefficiencies in the marketplace looking at rebates. It’s a big business. And we were able to take the Colorado all payer claims database, and you’re able to see right there in front of our eyes that rebates are a significant portion of the increasing cost when it comes to prescription drugs. And one of the very unique things about Optimal, and I love talking about this, is we provide employers and brokers the ability to [00:20:00] allow their clients the ability to receive a hundred percent pharmacy pass through on those rebates. And that’s a big deal. And so when it comes to the options, the employer, they can say Optimal, go ahead and you can go ahead and keep the rebates and we’ll give ’em a discount on their composite rates. And if the employer says, I like to have those rebates myself, it’s not going to be that much more of an increase in their composite rates, but it can be huge to those employer groups [00:20:30] and to be able to do that, but not just offer it, but offer it down to two enrolled employees. To me that’s cutting edge. That’s groundbreaking. That’s shaking up the healthcare marketplace. And we like to do that.

Jason Powers:

Not to get into a lot of down a rabbit hole, but there are some plans out there where the rebates aren’t shared. They’re part of their business model to really supplement some of the things they’re doing on the admin side. And so [00:21:00] just having the transparency of rebates being on the table as an option to share or not with employer versus you as the M G U I think it is different. It is refreshing,

Brad Williams:

Yes. And network options. So we offer a plethora of network options. You’ve got your traditional P P O plan [00:21:30] sometimes to reduce the cost a little bit more, we can offer an E P O type plan that basically is a P P O, that is in network only. There is no out of network benefit, and it’s a good strategy to reduce healthcare cost within the plan. We also have the High Performance Network through Cigna, which is the local plus network. Love that network. We’ve got it priced very attractively and it’s become a big hit in the marketplace. And those metropolitan [00:22:00] areas, that Local Plus has a presence. And of course the reference-based pricing and P P O models as well. The hybrid models are also very effective options for brokers to look at for their clients. So the thing about Optimal is we don’t have a matrix. Everything that we do is customized. There’s over 500,000 plan options that a broker can create. And I like to think about it as the broker can go in, they’ve got their easel [00:22:30] and their paintbrush and their color palette, and they can truly create a Picasso for each of their clients. To me that’s invigorating.

Jason Powers:

See you and Picasso. I was thinking like Mr. Potato and do I put his happy face on or his sad face on, but no, here’s a better analogy with the Picasso. Yeah, there’s a lot of flexibility and we’ve seen that already in the [00:23:00] proposals that we’ve started running through Optimal, and we’ll get into some of those plan options here over the next few slides I think. But there’s something for everyone. There’s certainly a way to build the product that fits the current solution. So if you’re just trying to match up benefits or if you’re trying to improve and tweak some things that you couldn’t really do before in a cookie cutter model, now you can inside the optimal [00:23:30] model. So all exciting stuff for sure.

Brad Williams:

Yes. And there’s a map of the availability of the local plus network here in the Kansas City area. It’s included St. Louis very big in Tennessee and Texas as

Jason Powers:

Well. Rick will be happy that we’ve got single Local plus down in Tampa. So that’s a plug for you, Rick.

Brad Williams:

And there’s the flavors of reference-based pricing. [00:24:00] So we can do full R B P, we can do light, and then we can do a hybrid model as well. So there’s just not one level of R V P. There’s three different ones that we can provide. And one things that we will do is we’ll discuss what could be a good alternative for the employer regarding R V P.

Jason Powers:

Yeah, I probably said this a few times already today, but I’d be remiss if I didn’t say it again. And that is R B P. I think [00:24:30] there’s enough data now in the healthcare space for R B P to be part of the conversation. I think brokers who may have shied away from R B P in the past owe it to themselves and their clients to take a look at it because it really can provide a solution that resets some of those price hikes that we’ve seen over the last few years. The rate creep is just incredible. Trend [00:25:00] is always 12 to 15% somewhere in there and be able to reset some of those price hikes that we’ve seen and not sacrifice benefit, where all we see in the fully insured space are just maxed out of pockets are growing up and deductibles are going up, and it’s still somehow a bronze level plan, right? Yeah. We just keep pushing the line out further and this is a way to kind of reset some of that

Brad Williams:

Stuff. [00:25:30] Exactly. Yeah. I like to call it kind like plan design bleeding, that it just keeps going higher and higher and the average American can’t afford the out-of-pocket maximums for their family. So we’re always looking for ways of how can we make the plan better, make it work better for the employer, make it better for the member, and it becomes a win-win. And with R B P, we’re also bringing the provider into the equation too. And so it’s just a solid solution. I call it the trifecta between the provider, the employer, and the

Jason Powers:

Member [00:26:00] onto the product catalog. These are the slides I was waiting for. This is the 500,000 different ways to run the proposal. You want a product grid? There you go. There you go. We got four slides here that tell you all the combinations we can run. Yes.

Brad Williams:

So I’ll share with you there that there’s a number of deductible options out-of-pocket maximums. [00:26:30] The broker community can pick and choose the one that they want to offer their customers and their clients office visits. The specialist copay is always twice the P C P. Right now we have an urgent care copay of a hundred dollars. It starts at 20 and goes as high as $50 for A P C P copay. We typically see the accrual type of plan as a calendar [00:27:00] year. That’s the most common. And there’s the network type. You can see that there P P O E P and RV P

Jason Powers:

Two 50 up to 9,000 on the deductibles. Certainly plenty of options in there.

Brad Williams:

Absolutely. And the thing to also add in there too is in terms of the schedule option is regarding that claim surplus account. We don’t require the employer to renew with us in order to retain their surplus. We believe it’s truly their money. [00:27:30] And so we don’t want to put one arm behind their back and do anything from a foreseeability standpoint.

Jason Powers:

Actually, I think next slide for me, Bob, I think, or maybe it’s I it’s coming up. I think it’s

Brad Williams:

Coming up next slide. But when you compliment the 500,000 plus benefit options available with the ability to give the employer options in their surplus, again, it’s truly a very effective strategy for the employer community.

Jason Powers:

And so we can go single plan option. [00:28:00] We can allow two plans for under 25, 3 for under 54th or 51 plus.

Brad Williams:

Yes. Yes. So it’s nice because that employer, they may want to offer a single plan. They may want to offer two plans. So a group of three that can offer two plans. I think that shows that we’ve got a lot of flexibility when it comes to plan design

Jason Powers:

Creation and then the geo network sliced, walk me through that. [00:28:30] I hadn’t heard it called that.

Brad Williams:

Yeah, so there’s times that for example, there could be an employee that is in let’s say Michigan, and we’ve got a network there First Health that there’s no option for them. That’s their network. And so we’re not going to really count that as a plan. We’re going to say that person has to be in First Health because of where they reside, and that’s what we call geo network slices. We’re kind of slicing out an exception for them in that case.

Jason Powers:

And similar, if you’re doing [00:29:00] a regional network in say, Missouri, and it’s regionalized, you’ve got someone that lives out of state, they’re not going to get

Brad Williams:

That’s

Jason Powers:

Correct. Penalized for having a different network for

Brad Williams:

Those employees. Exactly. So it comes down to the zip code. We don’t have penalize a plan or a member based on their zip code. Got it. We’ll make it enhanced.

Jason Powers:

Got it.

Brad Williams:

I like saying that word a lot.

Jason Powers:

Enhanced. Enhanced, refreshing.

Brad Williams:

Refreshing. Two good words.

Jason Powers:

So for nomenclature here we’ve got the [00:29:30] RX rebates. The delayed admin fee is the surplus return, right? That’s correct. Whatever the other side of that is, the admin, the delayed admin fee that you’re keeping. So we can do a hundred percent. A hundred percent if they renew 50%, 50% if they renew. So that is tied to the renewal or not 50% or a hundred percent either

Brad Williams:

Way. Exactly. And we include the IF renewal because if the broker like to shave a few more points off the rates, [00:30:00] we can do that and require the renewal if they’d like. And so we’ve built that in, but it’s not a standard part of our proposals. Whenever they see delayed admin fee, that is referring to the surplus option that the employers have.

Jason Powers:

That’s great. And then the RX rebates, I kind of skipped over that, but so you kind of covered that before. They can choose whether they get it as a pass through or not a portion of it. And you can also tie that rebate to the renewal, [00:30:30] which is important I think, to understand rebates aren’t immediate. They take six months to really develop.

Brad Williams:

That’s a good point, Jason,

Jason Powers:

And come back. So you can kind of tie that into that renewal as a strategy if you wanted to maybe shave some points off the admin and just make it a little bit more make sense if it’s a six month, six month return.

Brad Williams:

Right. Exactly. Yeah. Which is nice. Options are a friend. Yeah.

Jason Powers:

Again, half [00:31:00] a million different options. Right? Exactly. Can’t wait to run your proposal. No, I’m kidding. I got a team that does all that stuff. So Andrea’s going to love it. And more options. More options on stop-loss.

Brad Williams:

Yeah,

Jason Powers:

So what you’re saying is you can replace just about anything we’ve got out there.

Brad Williams:

Absolutely anything and everything. So we’re unique to that. If a company wanted to truly go self-funded in the marketplace, [00:31:30] typically it’s not been very kind for groups below a hundred to go fully go self-funded down to 51 employees.

Jason Powers:

I mean, I can only imagine the brains that were in the room coming up with this, they all came from probably different walks of life and said, well, here’s all the things that I’ve run into and here’s all the things I’ve run into. And you guys just pieced together this Mr. Potato.

Brad Williams:

Exactly. Yeah. You would’ve loved to have sit in our brainstorming sessions. It was fun. Just [00:32:00] the what ifs that we were talking about and why not, and then let’s do it. And so that’s been the fun part, and it’s just coming in and creating something that is truly unique and robust in the marketplace.

Jason Powers:

I mean, it really does look like there was a lot of attention to making sure that you weren’t in a situation where you couldn’t replace something that was out there.

Brad Williams:

Right? Yeah.

Jason Powers:

And here’s what we need, probably pretty similar to just about anything else that I [00:32:30] asked for. I don’t always get it, but things that we need to get a proposal, a broker’s probably out there thinking, well, how do I get started? Right? That’s what we’re hoping.

Brad Williams:

Yes. Yes, exactly. Let’s start. Let’s start now. Let’s get going. So I like to say that our process is very easy peasy. It’s easy. Just give us a census with some basic information. We run the quotes in our office and we typically can produce a quote within 24 to 48 hours, a preliminary quote with the preliminary [00:33:00] composite rates that they can show their customers and their clients and gauge an interest level and discuss what’s next. We do like to receive plan design information or sbcss to kind of give us idea of,

Jason Powers:

You mean you can’t just a plan with all half a million dollar different options.

Brad Williams:

Exactly. And I use the word carac and I’m dating myself now from Johnny Carson because there’s times I get this look from people like Carac, what are you talking about?

Jason Powers:

I don’t have the hat for

Brad Williams:

It. Exactly. So that makes me officially [00:33:30] that other generation. Now when I say take the envelope and people look at me and it’s like, okay, but yeah,

Jason Powers:

I get the reference.

Brad Williams:

I appreciate that Jason. We’re exposing ourselves. Yes, we

Jason Powers:

Are bunch of old guys.

Brad Williams:

And if there’s a plan design that the agent will like to request, just let us know. We’ll share information too in terms of there’s certain elements within our plan designs that may have a higher discount than others, [00:34:00] and it could be worthwhile to look at that as a plan design option. And then the employer contribution is also nice to have because we can control the ratio to rates or how much is that employee only rate compared to family? We can adjust it upwards and downwards as well. So that’s the initial part. And then once we get the nod to say, okay, let’s go forward with optimal, what’s the next step? It’d be completing the individual health questionnaires that we utilize for [00:34:30] groups between two and 50. I’m also excited to share with you that we’ve just recently announced our new express screen.

Jason Powers:

We did see this, yes.

Brad Williams:

Very excited about this. And so for groups that are between 20 and 50 enrolled employees, we’re using 10 states now. Let’s see, drum roll, if I can remember these states, but it would be Arkansas, Tennessee, Virginia, Kentucky, Illinois, Wisconsin. It would be Nevada and [00:35:00] Oregon. Did I do it? I think I did. Is that rent 10? 10?

Jason Powers:

I may have lost count again. I was told there would be no math. I don’t know if I need to include my toes on that one.

Brad Williams:

I know nothing. I’ve seen nothing. Right? Yeah. But the express screen is a two page app. It asks for medical history back to three years. Some information is requested for prescription drug utilization, [00:35:30] and it’s a way for us to respond quicker in that size category with a preliminary underwritten proposal and rates. It allows us just to come in with a quicker response to the marketplace. And it’s a pilot program. We do hope that we can roll it out to other states, but it’s something that we just started doing here recently, and so we’re very excited to announce this.

Jason Powers:

I think we kind of positioned, at least in our office, we positioned optimal, [00:36:00] particularly in Kansas and Missouri, but even outside of that, we’ve got brokers in 31 states. So we position this as we really want apps. You’re on all the major platforms, you’re on form, fire Ease, easy apps. Optimal is listed out there as an approved form in those programs. So most of the brokers we work with are doing apps. So we send us your optimal apps and we’ll get you an underwritten offer. Yes, [00:36:30] a competitive compensation package for brokers, again, we are a general agent, so we’re paid as an override. So all of the production credit and all the producer comp goes to the producer. We’re at 7% of premium equivalent for under 25, 25 to 50 at 6%, and then 51 plus we go 25 P P

Brad Williams:

1. Exactly. Yeah.

Jason Powers:

Took the words right out of your mouth.

Brad Williams:

You did Jason. Well done. And the nice thing about that too, it’s [00:37:00] the full composite premium, which you mentioned. So it’s not just based on the reinsurance or the stop loss portion, it’s the full kitten caboodle. It’s the full premium and the states that we are in. So we’re in every state except for Washington, California. We have filed for approval in those states just waiting on their DOIs to give us approval.

Jason Powers:

I remember California’s tough under a hundred. It’s just tough to get anything going on there. It is. And the level funded or

Brad Williams:

So we’re [00:37:30] just kind waiting there. And then of course in DC and Hawaii and

Jason Powers:

51 plus in Utah, it’s another tough state.

Brad Williams:

Yes, yes. Other than that, we are all over the United States, so we can do,

Jason Powers:

I think we might have some stuff in Utah, but I think the rest of the brokers that we’re talking to are going to be in the other states where you do write business. So that’s another reason we’re excited.

Brad Williams:

Yes, it’s fun to talk about this. And then if you look at why optimal, [00:38:00] what are the long-term advantages of working with optimal benefits? I think it’s our pricing and underwriting precision. I want to use that word precision because that’s one of the hallmarks of optimal is our ability to evaluate a risk and correctly price a risk We’ve seen with another carrier. What can happen when you don’t properly evaluate a risk and price it properly? You won’t be around to offer commercial health insurance. And so

Jason Powers:

Some of those are around for a long time until [00:38:30] they make some missteps. Yes. And so

Brad Williams:

We want an employer that when they move to optimal, it’ll be the last change they ever make. And we mean that. And so being able to price that risk properly is key to renewing the business. It’s key to stability. It’s like the domino. Everything falls in place nice and neat when you do things right the first time. And so that’s one of the key things about optimal. We’re dedicated to broker distribution. [00:39:00] Doing business with brokers is a hundred percent of what we do, and we only work through and with brokers. That’s how we build critical mass in the marketplace with optimal independence. We are truly independent. We are beholden to no one. We’re not beholden to stock brokers and worried about stock price. We are not owned by any particular insurance companies or healthcare systems. We are truly independent and we are transparent as we’ve been talking about transparency, [00:39:30] it’s coming a lot come up a lot in our conversation today, Jason.

And transparency is a key thing with optimal what we can bring the table, being out in the dark and not being in the know is not a pleasant position to be in as an agent, but to be able to have the transparency and the facts, the logic and the data to properly consult that employer client is very important. And that’s what we bring to the table with our transparency and of course, flexibility and creativity. [00:40:00] I like to joke about that because our teacher used to always get onto me because I always had this knack of wanting to color outside the box, and I was told not to do that. And with optimal, we love coloring outside the box. We like to be innovative. The status quo is not good for us. Innovation is good for us. Innovation and transparency and technology is great for the marketplace. [00:40:30] And so that’s a huge differentiator for us is that we want to partner with the broker and agent community, and we want to be able for them to be able to provide that unique, customized solution for every employer and every client. And it’s huge.

Jason Powers:

Well, and we can see that in everything that you’ve built in this product, I think I’ve said it, when we first started reviewing all the things that optimal brings to the table, we [00:41:00] recognized the flexibility, the creativity, the transparency, and there are brokers out there in the community that we work with that are looking for that same opportunity to get in front of their clients. So I envision on the other side of this camera, there are brokers just chomping at the bit to get to talk to you in the near future here. So any last words of wisdom for brokers as they head out to busy season and start selling optimal?

Brad Williams:

Yes. Thank you, [00:41:30] Jason. As you are looking for options and alternatives and you want to experience what better looks like in level funding, think of optimal benefits. We are here to support you. We’re here to support your clients, and we understand the trials and challenges that you experience as a broker, and we want to become that value confidant you’re looking for in a level funding solution. So Jason, thank you for your time today. Yeah, [00:42:00] really appreciate being here and being able to talk with you and the brokers that you partner

Jason Powers:

With. Well, we appreciate everything that you’ve done to get us on board. We are, again, we’re ready. We got operators standing by waiting for your quote request,

Brad Williams:

So make that call.

Jason Powers:

We’re ready to quote your optimal business. If we can help you in that regard, please contact our quoting team down below this video on our website. We will post links to [00:42:30] a lot of the marketing flyers and additional supporting documentation that you’ll need to build confidence in your presentation with your prospects and clients when you’re out there representing optimal benefits. Thank you again, Brad, for being here.

Brad Williams:

My pleasure.

Jason Powers:

Thank you you, Jason. Thank you brokers for tuning in. This concludes our optimal presentation. Happy selling. Until then, we’ll see you next time.

Brad Williams:

Talk to you soon. Bye-bye.

Jason Powers:

Thank you for watching this edition of our carrier product update series. [00:43:00] Visit our website to watch other episodes.