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Companion Protect Pet Insurance Company - Episode 53

station description Health Insurance Isn't Just For People Anymore
Pet Insurance Guide Podcast
Duration: 39:55
Interview with Taylor Worthington, an account manager with Companion Protect Pet Insurance Company discussing how their insurance is different from many other companies in the industry.
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Interview with Taylor Worthington, an account manager with Companion Protect Pet Insurance Company discussing how their insurance is different from many other companies in the industry.
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today I'm introducing you to a pet insurance company who is offering pet owners a different kind of pet insurance coverage and after the interview I'll share with you some of my thoughts from a veterinarian's perspective on the company. So here's today's guest companion protect started in 2015. And I have as my guest today Taylor Worthington an account manager with the company to give our listeners the scoop on what sets companion protect apart from the rest of the industry. Taylor welcome to the pet insurance guide podcast. Yeah thanks for having me happy to be here. What are your primary responsibilities as an account manager companion protect. My primary responsibilities will be essentially helping our current partners within our network. So that would be our network of veterinarians that we have across the U. S. It's myself and to others. We also have a director of the network program and we are in charge of making sure that everything is running smoothly with all of our clinics. Each of us right now have Between 40 and 50 clinics that we managed throughout the US so whether that be holding trainings with the claims process, whether that be showing them new innovative ways that they can offer our insurance to their current clients, making sure that they know that we are an option in terms of long term care for the health of their pet within their clinic. Uh things like that. What are the advantages to the pet owner for going to a veterinarian that is in your network. A couple of the biggest things we actually offer a direct payment option at all of our network partners. So what that looks like is um you're going to go in to a veterinary clinic that's partnered with us. You as the pet parent would be paying a $50 deductible and a 10% copay and then you would be completely done, you would leave the clinic, You don't have to worry about filing the claim. We have people at the clinic filing those claims on your behalf. Now there's another advantage we're about to talk about when we contrast that with a client going to an outer network clinic. What's the difference? So if you go to an out of network veterinarian You would be paying a 20% copay and a $100 deductible as opposed to that 10 Copay and $50 deductible. Additionally, if you are going to an out of network veterinarian, the claims process will work very similarly to all other pet insurance products. So once you're done um the veterinarian will give you uh the paperwork, the medical notes, the invoice that you need to submit to us. You would be submitting that on your own and then um we would be reviewing that claim and getting back to you instead of being completely between the veterinary clinic and us as an insurance company. Okay so how long after an end network veterinarian submits the information. Can they expect reimbursement, We commit to review a claim within 24 hours. So once that happens it normally takes a day or two to complete a review and a secondary review of the claim. So for the entire process it's normally going to take 3-5 business days when it comes to getting reimbursed for that. Okay. And how do you reimburse the veterinary hospital? Yeah. Great question. So we do one of two ways we either go through a CH. So direct deposit through whatever bank they're using or a check. Obviously a CH is going to be a little quicker but we still offer the check as a secondary option. Okay and how about clients whose veterinarian is out of network? What's the claim turnaround time there? Well it'll be just about the same. Um Honestly the biggest differentiator in the process in general is just going to be how long it takes for us to get all the necessary documents in order to finish the claim and begin review when a veterinary hospital submits the information for a claim. Do they do it usually right at the time of check out or do some of them say wait till the end of business day or maybe the next day or how does how does that work? It just depends on the day. Some days they're very backed up. I don't have time to submit the claim that in there within our portal. We do have the option to save and continue later. We obviously asked that they submit those as soon as possible because at the end of the day if you're in in network veterinarian, um the sooner you submit the claim, the sooner you get reimbursed. But like I said, just depends on the day. Sometimes they have a lot of time and they can submit had been in there other times if they have a lot of emergencies coming in or their calendars filled up, it'll take a little bit longer. I can imagine veterinarians might be reluctant to get involved in a network for a couple of reasons. Uh and I'd like you to address them number one, they may associate the term network with the human model where doctors and hospitals are reimbursed a negotiated amount that is discounted from what they usually charge for their services. Right. So we do not change any veterinary practices pricing structure once we're working with them. So whatever their pricing model was beforehand, in terms of partnering with us, that is what we go on. We have never and will never change any pricing at a clinic. Okay. And the second thing they might object to or might come to their mind is I'm going to need extra staff just to handle insurance claims. Right? And we have definitely heard that before. I will say that the portal that I've been referring to is as efficient as we can possibly get it at this point in order to submit a claim, it takes five minutes there two screens, probably 15 clicks um and like I said, you do have the option to save and continue later. Again at the end of the day, we would like to think that the people that we're partnering with can take that extra five minutes or so depending on how many pets they're seeing with our insurance that they that it will be worth it in terms of the increased compliance and the people that they're seeing more often than not that they wouldn't have been seeing if they hadn't had our insurance. Okay. Your work partners, I mean are they free to accept insurance from other companies? So it's not any exclusivity or anything like that? No, we we do not have an exclusivity clause in our agreement at all. Okay. Are there clinics in all 50 states? So as of now we do not have clinics in all 50 states. I think we are right around 30 but we have a team of um network expansion managers that are working every day reaching out to new clinics, seeing if they would like to Join in the network so slowly but surely we will get into all 50. Is the focus primarily metropolitan areas or do do you also have some partners that are maybe in more smaller communities right now? We are focusing on more of the larger metropolitan areas. We're also focusing on studies that have been done in terms of more pet friendly cities. So targeting notice first and foremost. And we're also going to places where we see that we have clients or pet parents. So um kind of catering to their needs because at the end of the day, um the network is for our pet parents and so if we have people in a certain city and they're wanting to utilize our network but we don't have a partner there, we're going to target in on that just to make sure that we're catering to the people that have our insurance. We have probably a few clinics a week right now that have claims of people that are coming in but they aren't yet a network partner. And so those are obviously going to be ones that we're going to target. So that would be an instance where we would be reaching out. We would be saying hi, I saw that you saw fluffy a couple days ago and they ended up submitting a claim. Here are some ways that we could have actually saved them money. We would love to further discuss some of the benefits in terms of joining our network and how we can make it beneficial to both us as well as you as a practice can An out of network veterinarian agreed to accept direct payment from companion protect if the client can't afford to pay the full cost up front, understanding that there will be subject to a higher copay and deductible. Uh no, we would not be able to do that. So that is one of the driving forces behind being a network partner. So if that was the case and we had someone reaching out about that, that would be a great start to a conversation of what it would look like to become a partner. Okay. You prominently display on your company's homepage that you have the industry's leading claim approval rate. What does that mean? So as of now we are sitting at 97% in terms of our claim approval rating. That's pretty good, very proud of that. Do you know what the industry averages? I could not tell you if I had to guess, I would say it's probably somewhere in the high 70s. Okay. Why do you think yours is higher? I would say a big part of being so high is because of our transparency when it comes to identifying pre existing conditions up front. So what it looks like whenever you are enrolling, if you have medical data from the past 24 months, you can submit that or we would do an enrollment exam out of network partner once that's done. That is when we will be identifying those pre existing conditions. So from the time of enrollment, you know exactly what's going to be covered and what's not going to be covered. And then additionally, in terms of the portal, our pet parents also have access to their own version of the portal while they won't be able to submit claims or anything because that's done on their behalf by our network partners, they still have access to see all of the pre existing conditions, all of our exclusions. So as I said before, we really pride ourselves on being as transparent as we possibly can be. You know, that's really huge knowing upfront what's covered and what's not covered as far as the parent goes. Uh, and really it's important with the veterinary hospital also, if an enrollment exam is necessary with an in network that partner, that's a free exam. Right, correct. So whatever the cost of the exam would be, we would be reimbursing the clinic for that. What if it was an out of network veterinarian, we would need to have the enrollment exam done at a network partner right now. You know, you got a large area of the country that doesn't have in network veterinarians. So if a client of a veterinary hospital that has an out of network veterinarian signs up, then the outer network veterinarian can't perform an exam, an enrollment exam. So they would be able to, but we just wouldn't be reimbursing them for pet insurance companies base their premiums on the age of the pet, the species, whether it's a dog or I can't the breed and where the pet parent lives. What factors does companion protect consider when setting premiums. So it will be based on three things, it will be based on the species of the animal. So whether it's a dog or a cat, Um the age of the animal, so whether that animal is under the age of seven or over the age of seven and the third determining factor will be the zip code. Okay, so you only have two tiers of premiums and when you say the age of the pet, you mean at sign up. Right? Yes, for example my dog Apollo, he's four years old. So whenever I enrolled him, he was three and from then until the end of his life he will be covered under that premium. That is the under the age of seven premium. So even after he gets over the age of seven he'll still be paying that under the age of seven premium. So just to be clear, Companion protect doesn't increase the premium based on age as they age, correct? So we do not increase the premium as if at ages and we also don't cut off coverage at any point. Okay I want to mention that I live in Memphis Tennessee and I did get a quote for each tier here in Memphis. I also got a quote for calabasas California which is uh northern suburb of L. A. And I want to give those right now just for a comparison a two year old dog In Memphis. The premium is $44.99. A two year old dog in Calabasas is $59.99. Obviously the cost of living in California is higher than it is here in Tennessee. So that a little bit different. A 10 year old dog in Memphis is $67.99. And a 10 year old dog in Calabasas is 89, A two year old cat in Memphis is $22.99. And a two year old cat in Calabasas is $29.99. A 10 year old cat in Memphis is $33.99 and a 10 year old cat in cala passes his $44.99. So one thing that jumps out right there is, cat premiums are roughly half dog premiums a lot less expensive. Yes, correct. I think I recently saw the stats from Like 2019 that About 83% of the pets insured or dogs and only 17% or cats. Um so I don't know whether it's a matter of cat owners just not realizing how inexpensive pet insurance is. I know there are other factors that probably play into it. Probably a lot of cat owners think, especially they have an indoor cat that my cat will never get sick, never get hurt. You know, he's never outdoors, you know that type of thing, but as a veterinarian. I know and I'm sure being in the industry, you know, uh that's not always true. Indoor cats can get some pretty large veterinary bills too. Yeah. Absolutely. So I'm I'm just amazed. I think cat owners need to take a closer look at pet insurance just for those reasons. Yeah I would agree. Your deductible is a per visit deductible. Right, correct. So what does that mean? That means every time you come into a clinic no matter what it's for, even if you're coming in for four or five different things that you think may or may not be wrong with your animal, we will still only be charging that singular deductible. So you wouldn't be charged a deductible per instance it would just be per visit. Okay so you don't have an annual deductible, it's just a per visit, correct. I'm just going to go over an example to kind of clarify that for instance the dog comes in for itching and the following problems are identified. Probably an allergy as an underlying cause of the itching pa derma or skin infection and an external ear infection. Usually all related to allergies. Right? Some companies might have a per incident deductible where there would be a deductible for each of those problems. You're saying that with companion protect there's only one deductible for the visit no matter how many problems are identified on that visit. Is that right? Exactly. Is the wellness exam included in your coverage? Yeah, that's a great question. Um That's that's also a big part of our company in what we cover? So we are going to cover one free annual wellness exam per year for a pet that is under the age of seven. And then for animals over the age of seven, we're actually going to cover to free annual wellness exam. So once you do enroll we would have a six month waiting period until you were eligible for that first free annual wellness exam. After that said you'll get one free per year if it's under the age of seven and then to free if it's over the age of seven, A deductible of $50 will apply to an after hours visit to an end network emergency clinic. A deductible of $200 will apply to an after hours visit to an out of network emergency clinic. How many emergency clinics do you have in your network? We do not have too many. Um That is something that we're definitely starting to look at more and more. But As of now, I would assume that it probably will be that $200 out of network deductible, especially if it is after hours. You do require pre approval for the following surgical procedures. Veterinary specialty fees, overnight Hospitalization services over $2500. Treatment for hip dysplasia tissue and organ transplants. But you did say that an emergency situation is an exception, correct Your policy states that for services requiring preapproval companion protect, reserves the right to select the provider of any surgical procedure. What does that mean? So essentially what that means is that if we see that one person is charging one amount for a surgical procedure and someone down the road is charging another amount. That is vastly different. We would just ask that you would go to the one that's more in line with the cost of veterinary care in that area. I will say though we have not run into that in the last five years. So I mean I guess you also take into consideration that specialist is gonna charge more than a primary care veterinarian for the same procedure. Yeah, that's true as well. So what about policy maximums? So we have a $100,000 lifetime maximum stepped in Illinois. And in Illinois it's a $20,000 maximum per year. But that's only due to state insurance regulations. So in every other state there's not an annual limit, correct? Just lifetime. Okay. What about waiting periods? Um I know that that's a big thing with other insurance companies. Um We think that we, as I touched on earlier should be doing it right from the beginning. So we don't have any waiting period. So from the moment that your pet is enrolled you have full coverage. I guess the main determining factor of when they're enrolled is after you've done the medical record review or they've had that enrollment exam and you've identified what's pre existing or not at that moment. They become enrolled? Not necessarily the day they sign up, correct. Do you cover bilateral conditions? Yes, we do. Okay. For people who don't know, most companies will not cover bilateral conditions. The most common example given is torn cruciate ligament in one rear leg. If a pet has had, say, a torrent cruciate in the right leg before sign up and after sign up, they later tear the christian in the opposite leg. It won't be covered even though it occurred after sign up because it's considered a bilateral condition. The main reason for that is when it comes to things like cruciate especially or even cataracts, glaucoma. You know, things like that. If something occurs on one side of the body in a lot of cases it's more likely to occur on the opposite side of the body. So a lot of pet insurance companies don't cover that. But you're saying that if a client had a dog that had a torn cruciate in the left leg previous to sign up and they signed up and then a year or two later had a torn christian in the opposite leg, you would cover the opposite leg. That's correct. Okay, Very good. Okay, So it's going to a few things here. What's covered? Not covered prescription foods. Yeah. So we will cover 50% of all prescription foods. So that would essentially just come out to be a 50% copay on that. Okay. There's, there's no deductible on that? Right, nope. Okay. And that's huge from my perspective as a veterinarian, there's a lot of pets that are on prescription foods and we use some of these diets for diagnostic purposes and we certainly use most of them for treatment of specific conditions. So in my mind it ought to be covered. Some pet insurance companies say, well it's food they've got to eat anyway. So we're not going to cover that. But prescription diets cost quite a bit more than what people normally pay to feed their dog, understandably. Its especially designed diet. Right? When you're covering 50% of the diet, I mean you're making up for that extra cost. Mhm. Exactly, prescription medications. Yeah. So for prescription medications, we are covering 90% of prescription meds. Okay. or 80% for out of network. That's correct. Ok, alternative therapy coverage. So we will cover all kinds of alternative therapies. So things like hydrotherapy, chiropractic care, laser therapy, homeopathy, I mean, you name it, orthopedic Care. Up to 10,000 dollars per site. Right? Per site is just what part of the body? Dental problems related to accidents, but not dental illnesses such as periodontal disease. Yeah. Okay. So if a tooth is damaged due to an accident like chipped or whatever? Like getting hit in the mouth with something. Do you cover extraction only or if it's a vital tooth, Like a canine tooth or 4th upper pre moller will you cover things like root canal and crown to try to save that too. If it was due to an accident then we would be covering that. But if it was due to something that wasn't done in terms of preventative care or something like that, I don't know. Do you cover supplements recommended by veterinarians to treat covered conditions? Right. So we cover vitamins and nutritional supplements if they're recommended by a doctor for an accident injury or an illness. Uh So uh for example, a lot of doctors will recommend In Omega three supplement for pets that have arthritis. And that's covered as long as we have documentation that it was doctor recommended. What about behavioral diagnosis and treatments for things like separation anxiety, obsessive compulsive disorders and so forth. Yeah. So we do cover the medical management. So medications for anxiety supplements and etcetera. We do not cover any training that's needed for things like aggression, anxiety and stuff like that. Okay, but you'll cover like a behavioral specialists, evaluation and medications and that type of thing. Is that right? So we recovered the medications for anxiety and supplements. Okay. Will you ever downgrade coverage for individual policyholders based on what you consider to be excessive claims? No. Uh We have not had an instance like that and we would not do that. That's essentially just them using our coverage which is what we want. And and we already talked about the premiums, you wouldn't raise premiums on individual policyholders based on claims experience either I guess not based on claims experience. No. Okay but taylor I really appreciate you being a guest on the podcast to explain the details about companion protect. You know it's it's one thing if a pet owner goes to your website and read what's on your website and all of that but it's a totally different thing. If a pet owner can listen to a representative of a company talk about the vision of that company, what they think sets their company apart from the rest of the industry. It just makes a whole lot of difference to get that type of input when a pet owner is making their decision on what company to buy a policy from. Yeah absolutely I totally agree. I'm happy to do it. Happy for anyone who's listening to consider us and obviously if they have any questions feel free to go on our website give us a call. I'm sure anyone that picks up the phone will be more than happy to talk your ear off about how we're better than anybody else. So give your website address again. Yeah so it'll be companion protect pet insurance dot com. Okay very good. Well once again Tyler thanks a bunch. Yeah thank you. Here are some of my thoughts about companion protect. First of all they automate the direct pay option through their vet work partners while also offering a lower deductible and copay as well as free wellness exams. One of the most viewed articles on my blog is about direct payment to veterinary hospitals. This is popular because it allows the pet owner to pay only the deductible copay and for any items that aren't covered by the policy. While the veterinary clinic files the claim and receives direct reimbursement from the insurance company for the balance. The only other company I know of that has the direct pay option automated at this time is true opinion in hospitals that use their true opinion expressed software because true opinion also identifies preexisting conditions up front And they have claims adjusters on call 24/7. They are able to approve claims and reimburse veterinary hospitals. Usually the same day the claim is filed. Companion protect doesn't yet have the ability to turn around claims that fast. They seem to have almost everything needed in place to do so except 24/7 claim approval. In my opinion, this is crucial to get more veterinarians on board with a direct pay option which pet owners want and can be a win win win proposition for pet owners, their pets and veterinarians. I've often said that the pet insurance industry will never grow like it aspires to without changing from the reimbursement model to the direct pay model. I want to address the reluctance some perhaps many veterinarians have of joining a network or the direct pay model. I understand this. I'm also a veterinarian. Neither true pan yin or Companion protect in offering their direct pay methods regulate how much a veterinarian can charge or what procedures they can perform. It will be up to these companies and others who want to provide a direct pay option to convince veterinarians of the benefits of accepting direct payments from the insurance company. I'll provide a link in the show notes to a page where you can find where Companion protects vet work partners are located. As taylor said. If a Companion protect policyholder doesn't have an in network veterinarian in their area or they just prefer seeing an outer network that they'd like and trust. Then their policy will operate similar to most other pet insurance companies that don't offer a direct pay option. Another thing that stood out to me about Companion protect is their commitment to transparency when it comes to letting new policyholders no up front. If there are any pre existing conditions that won't be covered. This is huge and sadly not many companies are willing to do this. This also allows Companion Protect to have a very high claim approval rate. Companion protect only has two tiers of premiums under the age of seven and over the age of seven, which is good in my preliminary investigation of the company it appeared like whatever premium I pay when I sign up will be the same the rest of my pet's life. My first thought was that's just too good to be true. All pet insurance companies will eventually adjust premiums up or down when they periodically refile terms and conditions with each state Department of insurance. It sounds like companion protect is really saying that even if they raise premiums in the future, a pet will always pay the going rate for the tier they were in. When they first signed up, Taylor said that so far existing policyholders haven't had their rates increase. They're per visit deductible is unique. Their policy also states if he returned to a vet for a recheck visit within 72 hours of the initial visit, the deductible is weighed for the second visit. Most companies have an annual deductible which is the most predictable for annual expenditures. I tried to draw the distinction by the example I gave in the interview between a per visit deductible and a per condition deductible. Where you pay a deductible for each new condition diagnosed in a visit. Companion protects seems to also be unique in that there are no waiting periods other than the initial review medical records so that they can determine the presence or absence of pre existing conditions after this coverage begins immediately and they don't have a special waiting period that is longer for certain conditions like orthopedic problems. They are also the only company I'm aware of that covers bilateral conditions. I like that they cover 50% of the cost of prescription diets, alternative therapy supplements and medical treatment of behavioral disorders. There are a couple of potential negatives of their policy. One is the $100,000 lifetime maximum. The vast majority of policyholders will never have to worry about reaching this limit. But some might. And it will be interesting to see if the company doesn't have to eventually raise this limit simply due to inflation. Although they cover treatment associated with dental accidents, they don't cover dental illnesses like periodontal disease. So their dental coverage is more limited compared to some of the other companies. I would encourage you to go to the companion protect website and check them out. Call them if you have any questions and be sure and read a sample policy in case anything changes in the future.
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