For agents, agencies, and individuals
Explaining the four costs together
Clients compare premiums because a premium is one number. Your job is to make the other three visible before they choose.
Four numbers, one decision
Why is the premium a misleading place to start?
Because it is what you pay to have coverage, not what you pay to use it. A household comparing only premiums is comparing the cost of the door, not the cost of walking through it.
How should I explain a deductible?
As the amount the household pays for covered care before the plan begins paying its share. The useful follow-up is which services apply before it is met, because that varies and it surprises people.
Copayment or coinsurance: does the difference matter?
Yes. A copayment is a fixed amount you can predict; coinsurance is a share of a cost you cannot know in advance. Households planning around a known expense feel that difference sharply.
What ties them together?
The limit on what the household can pay out of pocket in a year. It is the number that answers the question people are really asking, which is how bad a bad year could get.
Making it land
What is the most useful question to ask a client?
What care do you expect to use this year. A household expecting a surgery and one expecting nothing should not be shown the same plan, even at the same price.
How do I avoid overwhelming people?
Give the four numbers once, then talk in scenarios: a quiet year, a year with a surprise. People decide with stories more readily than with tables.
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