Health insurance broker visually explains coverage options and deductibles

The Small Business Challenge

James Chen starts his Wednesday reviewing three appointments with small business owners shopping for employee health plans. His first call is with Sandra, who runs a marketing agency with twelve employees.

“I’ve been staring at these quotes for two weeks,” Sandra admits. “PPO, HMO, high deductible plans – I have no idea what’s best for my team. The spreadsheets from carriers make my head spin.”

James knows this frustration well. Before CrankWheel, he’d spend entire calls trying to verbally explain plan structures while clients shuffled through email attachments. Now he has a better approach.

Making Coverage Visual

“Let me show you exactly how these plans work,” James says. “I’ll share my screen – just click the link I’m texting you.”

Within seconds, Sandra sees James’s comparison chart on her laptop. “Here’s the fundamental difference,” he begins, highlighting columns. “HMO requires choosing a primary doctor and getting referrals. PPO lets employees see any doctor but costs more.”

He pulls up a network map. “Your office is here. See these blue dots? Those are in-network providers for the HMO. The yellow dots show additional PPO providers. Notice how the PPO gives three times more options.”

“But the PPO is $200 more per employee monthly,” Sandra points out.

Breaking Down Real Costs

James navigates to his cost calculator. “Let’s look at actual employee costs, not just premiums.” He enters common scenarios.

“Employee visits doctor for flu: HMO costs $25 copay. PPO costs $40 until deductible is met, then $30.” He adds more examples in real-time. “Employee needs MRI: HMO requires referral and pre-approval, costs $150. PPO typically allows direct scheduling, costs $500 until deductible.”

He creates a simple bar chart. “For healthy employees who rarely visit doctors, HMO saves money. For employees with ongoing conditions or those who value flexibility, PPO might be worth the premium difference.”

Sandra asks about the high-deductible plan. James switches screens to show an HSA illustration. “This pairs with a Health Savings Account. You contribute pre-tax dollars.” He demonstrates the triple tax advantage with animated arrows showing money flow.

The Deductible Confusion

“I still don’t understand deductibles versus out-of-pocket maximums,” Sandra says.

James opens his visual explainer. “Think of it like this.” He draws a simple diagram. “Deductible is the amount employees pay before insurance kicks in. Here’s a $2,000 deductible. Employee pays first $2,000 of medical costs.”

He adds another layer to the diagram. “After deductible, you pay coinsurance – usually 20%. Insurance pays 80%.” He shows how costs are split with color coding.

“Out-of-pocket maximum is the safety net.” He draws a ceiling line. “Once employee pays $6,000 total – including deductible and coinsurance – insurance covers 100% for the rest of the year.”

Scenario Planning

“What if someone gets really sick?” Sandra asks.

James shares his scenario modeler. “Let’s say employee Tom needs surgery costing $30,000.” He walks through the calculation step-by-step on screen.

“With HMO: $500 deductible, then 10% coinsurance up to $3,000 out-of-pocket max. Tom pays $3,000 total.”

“With high-deductible plan: $5,000 deductible, then 20% coinsurance up to $7,000 max. Tom pays $7,000.”

“But,” James adds, showing the HSA contribution screen, “if Tom has been contributing to his HSA, he’s using pre-tax dollars, effectively getting a discount on that $7,000 equivalent to roughly his marginal tax rate (often around 30%).”

The Prescription Drug Maze

Sandra mentions several employees take regular medications. James pulls up his formulary comparison tool.

“Each plan has different drug tiers.” He shows a pyramid diagram. “Generic drugs in Tier 1 might cost $10. Brand names in Tier 3 cost $50. Specialty drugs in Tier 4 could be 20% coinsurance.”

He searches for common medications her employees mentioned. “Insulin is Tier 2 on the HMO, costs $35 monthly. Same insulin is Tier 3 on the PPO, costs $60.” He builds a medication cost comparison showing annual differences.

“Can employees see this information?” Sandra asks.

James demonstrates the member portal preview. “Once enrolled, employees access this portal. They can search doctors, check drug costs, even see their deductible status in real-time.”

Budget Impact Analysis

“I need to stay under $8,000 monthly for all employee coverage,” Sandra states.

James adjusts his spreadsheet, showing different contribution strategies. “If you pay 70% of premiums, HMO keeps you at $7,200 monthly. PPO would be $9,800.”

He shows an alternative. “What if you contribute a flat $500 per employee? HMO costs you $6,000, employees pay $150-300 based on coverage level. PPO costs you $6,000, employees pay $350-500.”

“Some companies do defined contributions plus HSA funding for high-deductible plans.” He models this approach. “You give $600 monthly per employee. They choose their plan. You add $1,200 yearly to HSAs. Total cost: $8,400 monthly, employees get more choice.”

The Decision Matrix

James creates a decision matrix on screen. “Let’s score what matters most to your team.” He lists factors: cost, network size, flexibility, prescription coverage, ease of use.

As they discuss each factor, he adjusts weightings. The matrix calculates scores for each plan. “Based on your priorities, the HMO scores highest, but it’s close.”

“Can I share this with my employees?” Sandra asks.

“Absolutely.” James uses CrankWheel’s video recording and sharing feature. “I’ll record a summary of our discussion. You can share the video link with your team. They can watch it before making their selections.”

The video gets shared instantly with an animated preview that catches attention in their inbox. James receives notifications when anybody watches the recording, helping time follow-ups perfectly.

Compliance Considerations

“What about ACA requirements?” Sandra inquires.

James shares his compliance checklist. “Your plan must cover these essential benefits.” He highlights each requirement, showing how all three options comply.

“Since you have twelve employees, you’re not subject to employer mandate penalties. But in two years when you hit fifty employees, this becomes critical.” He shows the penalty calculator for future reference.

He demonstrates the affordability calculation. “Employee’s share can’t exceed 9.02% of household income in 2025. Based on your lowest-paid employee at $40,000, their maximum contribution would be $300 monthly.”

The Enrollment Process

“If we choose the HMO, what happens next?” Sandra asks.

James screen shares the enrollment timeline. “Today is March 15. If you decide by March 20, we can start coverage May 1.” He shows each step with dates.

“Week 1: You sign master agreement. Week 2: We conduct employee meetings – I can do these virtually with instant screen sharing. Week 3: Employees make selections. Week 4: Carrier processes enrollment.”

He opens sample enrollment forms. “Employees complete these online. See how they select coverage levels, add dependents, and, if applicable, designate beneficiaries for life insurance or HSA.”

Employee Communication

“How do I explain this to my team?” Sandra worries.

James shows his employee presentation template. “I’ll customize this for your company.” He navigates through slides showing plan comparisons, cost calculations, and FAQs.

“During the employee meeting, I’ll screen share just like with you. Employees see their options clearly. They can ask questions in real-time. Much better than sending PDFs they won’t read.”

He demonstrates the benefits guide he’ll create. “This one-page visual summary shows all three plans side-by-side. Employees can reference it when making decisions.”

The Follow-Through

Sandra decides on the HMO with optional PPO buy-up. James immediately shows next steps on screen.

“I’m submitting your group application now.” He shares his screen as he completes the carrier’s portal. “You can see everything I’m entering. No surprises.”

He schedules the employee meeting. “Tuesday at 2 PM, I’ll conduct the virtual enrollment session. Employees join by phone, click a link to see my screen. Takes thirty minutes.”

“What about employees who miss the meeting?” Sandra asks.

“I’ll record it using CrankWheel. Absent employees watch the recording, then schedule individual calls if they have questions.”

Supporting Ongoing Needs

“What happens after enrollment?” Sandra wonders.

James shows his service calendar. “Quarterly, we review utilization reports together.” He shows a sample report. “We’ll see if the plan is working or if we need adjustments.”

“Employees can always reach out with questions. When they call me confused about a claim, I’ll screen share their explanation of benefits, walk through it line by line.”

He demonstrates his renewal strategy. “Next year, I’ll show you renewal rates versus market alternatives. We’ll model plan changes before making decisions.”

The Conversion Story

By the call’s end, Sandra has complete clarity. What started as overwhelming confusion is now an organized decision with clear next steps.

“This is the first time I’ve actually understood health insurance,” she says. “Seeing everything visually makes such a difference.”

James thinks about his afternoon appointments. Two more small businesses struggling with the same decisions. With CrankWheel, he’ll transform their confusion into confidence too.

His close rate has jumped from 30% to 65% since he started instant screen sharing. More importantly, his clients make informed decisions they don’t regret later.

The Multiplier Effect

After Sandra’s successful enrollment, she refers James to three other business owners in her networking group. “You have to work with James,” she tells them. “He actually shows you what you’re buying.”

These warm referrals convert at nearly 80% because they’ve heard about James’s visual approach. They call expecting clarity, and that’s exactly what they get.

James has built his entire practice on transparency. While other brokers hide behind confusing jargon, he makes health insurance understandable through visual demonstration.

The technology hasn’t just improved his sales – it’s transformed how small businesses approach employee benefits. His clients become advocates because they finally understand what they’re providing their teams.

By making the complex simple through instant screen sharing, James has positioned himself as the trusted advisor small businesses need to navigate the complicated world of health insurance.