Health insurance business plan sample

The majority of HMOs and PPOs have their own marketing and sales programs which include company employed sales forces. National insurance companies may have company sales people or may utilize independent insurance agents.

Health insurance business plan sample

The majority of HMOs and PPOs have their own marketing and sales programs which include company employed sales forces. National insurance companies may have company sales people or may utilize independent insurance agents.

Both have strong media programs. Neither, however, provide the mix of services that Southeast Health Plans can provide. Thus, Southeast feels that this entire employer universe of 1, companies is vulnerable to penetration. Industry Participants Insurance carriers provide economic protection only.

Health Plan Administration Sample Marketing Plan - Situation Analysis - Mplans

Such protection is at a high cost. Deductibles are increasing and the employer's ability to handle the cost burden of medical insurance coverage is diminishing. Compromises must be made in the extent of coverage, the size of the deductible, the medical services included, or often the employee is required to cover an ever-increasing percentage of the cost of his own plan as a payroll deduction.

These are all unattractive options both for the employer and the individual client. The spiraling cost of health care is the culprit. HMOs have gained substantial and significant market share over the past two decades.

Their cumulative share of covered insured employees now exceeds the national commercial insurance carriers by a wide margin.

However, these plans have been ruled primarily by cost containment strictures. Freedom of choice is severely limited—there is a perception that the quality of care is at an all-time low. Liability issues are beginning to surface based on compromised or neglected care due to cost parameters.

Many service costs are not adequately covered under these plans and the provider base of physicians are extremely dissatisfied with compensation allowances. Many physicians complain that the freedom of decision is diminishing constantly from time and cost constraints that are imposed upon them.

The ultimate client, the individual patient, is equally dissatisfied. Thus, the employer becomes dissatisfied as well. The market niche for the quality TPA is ripe for picking.

However, services must be of high quality. Many small TPAs are promising high levels of service but often don't deliver as promised because of the expense of building the internal resources required to compete effectively.

Southeast Health Plans, by virtue of its alliance with Blair Mill Administrators, already has the necessary resources in place. They employ media marketing and company sales forces to good effect.

The primary problem they face is increasing dissatisfaction with their product.


They will not be able to provide the multi-regional, customizable services that an increasing number of employers will demand. In addition, self-insurance is contrary to the buy-and-resell philosophy of these providers.

Many national insurance companies market through company sales forces and independent brokers and agents. Herein lies a potential barrier to entry into the small company market for an emerging TPA. Often the company has a pre-existing relationship with an insurance agent that may encompass a broader range of insurance services than health care.

The company is, in fact, buying a "package" of varied insurance coverages that are necessary to business operation and also happen to include health care coverage. The task here is one of general education about the potential of self-insurance programs. If the insurance agent doesn't provide this alternative, he stands to eventually lose the health insurance coverage.

But his current "franchise" with his client can be a barrier. It is the intention of Southeast Health Plans both to market directly and to work through independent agents to reach their existing clients. A competitive agent compensation program is in place to accomplish this objective.

Health Insurance Company Business Plan – FundingUniverse

It is the intention of the company to both work with independent agents who recognize the mutual value of co-operation or to sell in head-to-head competition with those who don't.

Ultimately, product, service, and price will prevail. All sales forecasts of the company recognize the timeline of market penetration, and have realistic, if not conservative, market share goals. Competition and Buying Patterns Buying patterns vary by the size of the employer and according to the internal organization.

The company with 50 to employers may have health care handled by the owner or a key executive. Often it is the responsibility of the personnel administrator as an individual if that function is internal to the company.

Also, the personnel administration may be outsourced, but benefits may not.XYZ Insurance Agency BUSINESS PLAN SITUATION ANALYSIS These carriers are supplemented by a limited number of financially stable life, health and disability carriers. Given these external and internal factors, XYZ business plan has the following organizational.

Sample Business Plan 13 USA health Club industry Although medical research has pointed out several benefits of body fitness and workout, still almost 90% population in America is yet to attend health clubs. Market Size: Total market size in Miami, Florida is almost million8 members.

Total population in. An health plan is a document which has a Care Plan on how we can maintain good health by employing good practises.

It is also for people to return back to good health in case of any health related issues. A Sample Insurance Agency Business Plan Template Insurance Industry Overview The insurance industry is wide and global in nature; there are numerous aspects anyone interested in starting an insurance agency could choose to specialize in.

health insurance business plan sample

Sample Business Plan Employee Wellness Program for (location) VA Hospital. Table of Contents. 1. Executive Summary 2. Description 3. Background Marketing Plan Employee health promotion programs and services will be marketed to all employees through email broadcasts, signage, and fliers.

Merely processing claims does nothing to help a business analyze and control its health benefits plan and to control the costs associated with the plan.

And there has not traditionally been a measure for the "quality" of health care service.

A Sample Insurance Company Business Plan Template