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.