How to Create an Illustrative Proposal
Step 1: Click on “+Add” or “Create a New Quote” to add a new group.
Step 2: Enter group details (requirements: group name, address, effective date, industry NAICS code)
Step 3: Upload a census (get a template here) that includes zip, dob, coverage level, gender. Or just add one person at a time.
Step 4: Add existing plan(s) to create a baseline comparison point to show your client including plan class, deductible, out of pocket max, coinsurance, office visit copay, and current premiums.
Step 5: Add current plan participation for each tier by entering them manually or click on “apply participation to plan” to pull it in from the census.
Step 6: Start your illustrative quote by adding pre-packaged programs (or skip to Step 7: create a custom program)
- Click on "Select a Pre-Packaged Plan"
- Select a TPA
- Click “add to model” to add to so that you can get pricing on this plan to estimate participation
- Add as many plans as you'd like and when you're done, click on "Get Illustrative Rates"
- Confirm your pricing request for your plan(s).
- Add your estimated enrollment for your plans and click "save participation."
Step 7: Create a custom program
- Click on "Create Your Own Program"
- Choose your TPA (or enter your own), enter the admin fee and give the plan a name.
- Create this health plan by entering the parameters of such as coinsurance copays, Rx co-pay and cost containment vendors.
- Set the expenses for the program you're creating including the PBM fee, advisor fee and any other pass through expenses.
- Add your stop loss contract type, attachment points, spec deductibles, TLO etc.
- Add your participation based on your existing plan or from the census.
Step 8: Preview your illustrative quote once you're happy with the plans you've added, click on the Preview button.
- To view the proposal, toggle between your existing plans, TPA and/or your custom plan name.
- Click on “long term outlook” to see cost projections for the existing plan versus your quoted plans and even edit the underlying assumptions.