What will 2020 bring for the U65 markets?

After years of double-digit premium increases on ACA plans, we are finally seeing stability, premium reductions, richer benefits.  Below we review Open Enrollment dates, ACA and non-ACA options for 2020.

You still need options for U65 clients, even if you are primarily in the Medicare or employee benefits markets.  While Medicare agents want to focus on getting clients into their pipeline early, employee benefits agents are regularly asked to assist clients who are asking for different solutions. Continue reading for some of the different U65 options that are available to your clients.


Clients who do not qualify for subsidies have no reason to sign up via the federal exchange, and many would not wish to share their income details in order to do so.  Whether via the federal exchange, or direct with a carrier, every client benefits from the education and support offered by a licensed advisor.  You just need an appointment, there is no additional certification needed to enroll clients off exchange in U65 major medical insurance.


The federal exchange, has a number of subsidies available for clients to take advantage of, in order to make their health insurance more affordable. While some agents decide to become certified to sell ACA plans, others refer their clients to colleague or fellow agent who specialize in subsidies and the federal exchange.

Agents who are certified to sell ACA plans bring a lot of value to clients who may otherwise find themselves self-enrolling. However, by self-enrolling, these clients may find themselves confused their benefits, and misunderstanding how networks and HSAs work.  For example, by choosing an HSA plan, a client could end up missing out on ‘free’ Telemedicine or doctor visits, which are available with similar priced non-HSA plans. Or maybe they could find themselves enrolled in a Bronze plan when in fact they qualify for the additional cost-sharing subsidies built into Silver plans.

ACA enrollment has been significantly dropping for those not qualifying for subsidies.  Enrollment currently sits at 10.9 million showing another 4% drop in 2019. Your middle class clients who are not eligible for subsidies will be wanting education on affordable, high quality options.

Short Term Medical

Depending on your local state rules, your clients will have access to plans with a duration of either 6-month, 12-month, or some other variation. Short Term Medical plans, which is a strong option for clients in transition, awaiting eligibility for a group plan, or looking to reduce expenses in the year before they age into Medicare. STMs are a must have option for all agents.

UnitedHealthOne offers comprehensive STM plans and year-long ACA alternatives with their multi-level ‘Health Protector Guard’ (HPG) plan options.  Click here to review UHOne STM and ACA alternative plans.

The IHC Group has been offering a wide range of STM plans for several years.  Click here to view IHC’s STM options.

TriTerm Medical.

Do you have clients looking for health insurance and wanting an option to ACA coverage?  UnitedHealthOne’s TriTerm Medical may have the combination of lower premiums, benefits and networks they are looking for. TriTerm Medical is limited duration Short Term Medical plan designed for nearly 36 months over 3 terms.

TriTerm Medical is available in the following states: AL, AR, AZ, FL, GA, KY, LA, MS, NC, SC, WV.

So, why should your clients consider TriTerm Medical?

  • Better benefits and longer coverage than traditional Short Term Medical plans
  • One-time enrollment coverage lasting nearly 3 years
  • Benefits include: hospitalization, surgery and medical emergencies
  • Preventative care
  • Office visit co-pays
  • Prescription medications
  • UnitedHealthcare Network Advantage
  • Some pre-existing conditions covered after 12 months

Learn More

Consider pairing TriTerm with UnitedHealthOne’s AccidentDental or TeleDoc (HealthiestYou) coverage.

Health ProtectorGuard: Simple, Straight-forward Benefits

Help your clients focus more on their care and less on their finances with Health ProtectorGuard (HPG), underwritten by Golden Rule Insurance Company. Choose from several plans that pay a fixed amount for covered services from doctors and hospitals. These plans are a great way to fill the gaps in your clients’ coverage!

Key features of HPG plans

  • Use any provider across the country; discounts available using the MultiPlan Limited Benefit Plan Network
  • No lifetime maximum benefit
  • No need to coordinate with other insurance
  • Rollover unused doctor visits from one year to the next
  • Benefit amount for injury-related hospital stays increases each year the plan is renewed
  • Prescription discount card included with every plan

Learn More

Accident and Indemnity plans

Modern high deductible ‘Cost Sharing’ ACA or non-ACA plans all suit pairing with Indemnity plans to cover first dollar and out-of-pocket expenses.  The high level of cost-sharing is one reason that clients without Indemnity plans are struggling to use their plans.  Agents are rapidly learning how to educate and present indemnity options alongside ACA, faith-based, and Medicare Advantage plans.

Remember, Indemnity plans such as Accident coverage often pay out cash sums and do not coordinate with client’s health insurance, meaning the money can be used for any purpose.  Indemnity plans make insurance work better.

Consider GTL for all of your new to Medicare clients. Consider UnitedHealthOne or LifeSecure for under 65 Accident and Hospital Plans, to ensure clients have coverage that allows them to use their health insurance

Read more about how to pair indemnity plans with your clients’ coverage by clicking here.

ACA Open Enrollment dates.

  • On Exchange:  November 1, 2019 thru December 15, 2019 for new plans beginning January 1, 2020.
  • Off Exchange (direct with carrier):  November 1, 2019 thru December 15, 2019

Get appointed

LeClair Group offers a wide selection of carriers to support your business.  To view the endorsed health insurance options for Thrivent FRs, download our Thrivent Product Portfolio or reach out to our team with your questions or training requests.

LeClair Group ensures your business gets the backing it needs to deliver fast, high-quality service to your clients. Better together, our expert sales desk team are here training and supporting your sales; backed up by industry leading quoting and illustration tools to grow your business.

To get started, reach out to us at 651.739.2010, email Licensing@LeClairGroup.com or apply online. Contact LaRae Mills or Weston Peterson on LeClair Group’s Health team with any additional questions.