- On May 21, 2024
Topic: Product Updates | Applies to: Small Group (1-50)
Medical Mutual is excited to announce new and improved COSE Benefit Plan and Balanced Solutions product portfolios. These updates will be available for new or renewing business effective Aug. 1, 2024.
COSE Benefit Plan
Product enhancements in this version of the COSE Benefit Plan portfolio include the introduction of Member Choice pairings. These pairings feature the same deductible at different price points with potential savings of up to 15%.
Selecting a Member Choice plan in both our PPO and HSA suite of plans gives employers the ability to propose four benefit offerings to best fit their employees’ needs.
The plans listed in the table below come with Member Choice eligibility. For example, if you select MC 1, your employer receives access to both the 20-3000 Rx and the 3020-3000 Rx. Or if you select MC6, employers receive access to offer both the HSA 3500 PD Rx and the HSA 3500/20% MMRx.
The COSE Benefit Plan suite has been expanded to 29 offerings and includes a few plan deletions. Those plans will be mapped at their renewal. Please reference the COSE Benefit Plan product grid for a full list of offerings effective for Aug. 1, 2024, new sales and renewals. Member Choice plans are referenced with an MC label within the plan grid.
Balanced Solutions
The Balanced Solutions portfolio was also updated to include 29 offerings. Balanced Solutions is our unique level-funded option for small group employers (10-50 enrolled) that offers an innovative alternative to traditional health insurance plans. This plan comes with the opportunity to earn a refund of up to 60% of the remaining claims fund.
Eligibility
To be eligible for the Balanced Solutions program, groups must have:
- 10-50 employees with at least 10 enrolled
- 75% participation of net eligible required
- 50% of enrolled must reside in Ohio
In addition, eligible employees must complete health questionnaires.
Plan Options
Balanced Solutions Plans include:
- Copay plans that offer 0%, 20% or 30% coinsurance options
- HSA plans that offer 0%, 20% or 30% coinsurance options
- Specific stop-loss amounts of $15,000 or $25,000
- Aggregate stop-loss attachment points of 110% or 120%
- An assigned employer fund to ensure that groups have no financial liability beyond monthly pre-determined premiums
Quoting and Sold Cases
The following COSE Benefit Plan and Balanced Solutions broker checklists were created to help you through quoting and sold case submission processes.
COSE Benefit Plan
COSE Benefit Plan checklists are located on COSEBenefitPlan.com under Tools and Resources > Forms and Documents.
- COSE Benefit Plan Sold Case Checklist
Balanced Solutions
Balanced Solutions checklists are located on MyBrokerLink > Producer’s Guide > Small Group > Non ACA Small Group Products.
- Broker Checklist – Quoting
- Broker Checklist – Sold
Resources
To help you sell these portfolios, we have recently updated several resources for your use.
COSE Benefit Plan
The following marketing materials are located on COSEBenefitPlan.com under Tools and Resources > Materials and Documents.
- COSE Benefit Plan plan grid flyer
- Member Choice one-page flyer
Balanced Solutions
The following marketing materials are located on MyBrokerLink > Producer’s Guide > Small Group > Non ACA Small Group Products.
- Balanced Solutions plan grid
Both the COSE Benefit Plan and Balanced Solutions brochures will also receive updates soon, and a broker update announcing availability will follow.
Please contact your ExpressLink representative with questions.