Stephanie Frisch and Carlos Aguilar Stephanie Frisch and Carlos Aguilar Photography by Diana Schmitt, Accent Portraits by Diana

Insurance 101: Insurance is Complicated, Understanding It Shouldn’t Be

Oct 30, 2017

They say those who can’t do, teach. But they also say that while we teach, we learn. In fact, Seneca said that. The Roman philosopher Seneca. So which is true? Stephanie Frisch hails from a family of teachers. And she would have to agree with Seneca. “I’m always learning. I want to know everything there is to know.” In the world of insurance, the demand is high for those who are dedicated to teaching the consumer, rather than taking them simply as a commission.

What do you really know about your insurance policies? Has anyone ever sat down and explained insurance to you in a way you really understood? Medicare Advantage plans, Medicare Supplements and Prescription Drug plans, Covered California, Individual and Family plans; chances are, mostly likely not. As the owner of Insurance 101 Services, Stephanie is taking an industry norm and turning it on it’s head.

“I come from an all-teacher family. I learned a long time ago how to properly and thoroughly inform my clients. And I believe that a personalized, caring approach is what it takes to garner trust with folks who at a base level, have no idea what the terms are, or what the provisions of the plans mean.” Specializing in senior needs - such as Medicare plans for South County residents, Stephanie is faced with unique situations daily. “As the demand grows for this type of service, I find that my successes lie in earning the trust of my clients. The actual business is just one factor. Caring for the whole person is the key.”

Her old-school approach is unrivaled. Rarely does a broker find the time to spend one-on one with a client, let alone achieving any sort of true human interaction in the world of text messaging, multi-password online applications, and automated 800-number customer service recordings. “I keep contact information and notes from past conversations with all of my clients. When someone calls me, I see their name pop up on my phone and I greet them personally. I love helping people, and bringing a personal touch to the impersonal world of insurance is key. You can’t rush when you do what I do.” Having the knowledge and savvy to navigate the insurance world is one thing. Having the patience to wade through the headlines and get to the heart of the issues speaks to a deep desire to do right by her clients. “It’s my responsibility,” she notes.

Sifting through the sludge of government issues, printed articles, and healthcare propaganda is enough to drive any American toward feeling as if the premium they are really paying is in lifeblood, not dollars.

“What I provide is ‘value added’ to what customers pay in their insurance premium,” says Stephanie. “I don’t personally charge for my consulting service. I’ve been told that my method of explaining insurance makes it easier to understand than any other way my clients have been told before. And I’m really trying to help them, not sell them. I want to know everything about the products I offer to people and what is going on out there. 65 looks and acts a lot younger than it used to. They want the information that will help them be proactive about their lifestyle, and I help them find that.”

Be it working, traveling, parenting, surfing, running marathons, practicing yoga - you should be informed. If you’d like to understand your options and benefits better, Stephanie’s the one to call.

Q: You’ve been a one woman show for more than 11 years now, what prompted you to bring Carlos Aguilar on board to Stephanie Frisch Insurance 101 Services?

A: Carlos and I are fellow Rotarians in San Juan Capistrano. He’s exactly the same age now as I was when I started my career in insurance. The company he worked for relocated and he was looking to find something that allowed him to work closer to home and his young family and still stay involved in the community of San Juan Capistrano. Carlos was born and raised here in San Juan and when I found out he was fluent in Spanish a light bulb went off in my head! This is what I have been missing in my business; the ability to help the large Latino population not only in San Juan Capistrano, but also the surrounding communities. Because of the language barrier for many, they don’t understand or even know about their options when it comes to getting help from Covered California or Medicare Advantage plans. I haven’t been able to help them up to this point but now Carlos can. I have full confidence in Carlos’s ability, and he has been trained by me and has full access to me with any questions in order to help him take good care of his client’s needs.

Q: So Medicare open enrollment starts October 1st and ends on December 7th.

A: Well, first off, even though open enrollment begins on October 1st, applications can’t be taken until October 15th, I wish that wasn’t the case. But October 1st is generally when Medicare.gov releases all the updated plan information for the 2018 Medicare Advantage plans and Stand Alone Drug plans. The drug formularies are also updated to reflect any changes made to what prescriptions are covered, how much they cost, if prior authorization is now needed or if there are quantity limits.

Q: Do you feel like there are good plan options out there for those Medicare beneficiaries looking to make a change?

A: I sure do. Especially for those that are in the St. Joseph/Hoag Health healthcare system and still paying for a Medicare supplement and prescription drug plan. It’s been about 3 years now that St. Joseph/Hoag Health has now been a part of the Medicare Advantage plan scene. These plans have great benefits, include prescription drug coverage, have additional add-on benefits to enhance the value of the plan and have NO monthly premium. They still need to continue to have the Part B Medicare premium deducted from their Social Security check (or pay it to the government if they’re not yet taking SS) if they enroll in one of these plans, but it’s a huge monthly savings for people.

As the demand grows for this type of service, I find that my successes lie in earning the trust of my clients. The actual business is just one factor. Caring for the whole person is the key.

Q: Let’s talk about health insurance for those under 65. Is the open enrollment time period the same this year?

A: In many other states it’s much shorter this year, but California has a strong commitment to making sure that no one is left without coverage. Open enrollment starts November 1st this year and ends January 31st just like last year.

Q: I heard that Anthem Blue Cross will no longer be offering insurance in 2018 for Orange County, is that right?

A: Well first of all, this applies to the individual and family plans purchased directly from Anthem Blue Cross and from Covered California only. But yes, that’s right. Anthem’s decision to pull out of Orange County (and many other surrounding counties) will have no impact on coverage for the remainder of 2017. In the 2018 renewal and open-enrollment periods, consumers will have to select another insurance company and plan. Anthem was more expensive in 2017 than Blue Shield and lacked the flexibility of a PPO, so I had already moved many people off of their Anthem plan last fall. 84% of doctors contracted by Anthem are also available through another health plans too, but that can be a tricky and time consuming task to research.

Q: What should someone do if they do have an Anthem plan and need to select new insurance for 2018?

A: Those Anthem consumers who have their coverage through Covered California and don’t do anything will be renewed automatically into the lowest-cost plan offered by another carrier in their same metal tier. This could mean major headaches as they realize that they no longer have the same access to doctors and hospitals. For those that bought directly from Anthem or through an agent, if they do nothing they will lose their coverage and have no insurance for 2018. This could be catastrophic! The best thing for people to do if they currently aren’t working with an agent is to get into contact with me. Carlos and I can help them find the best coverage to meet their needs and their budget.

Q: Looking back on health coverage in 2017, did any changes happen that you think people should be aware of?

A: Yes! As us July 1st, under a new state law, if you visit an in-network facility - such as a hospital, lab or imaging center - you will be responsible only for your in-network share of the cost, even if you’re seen by an out-of-network provider. The law applies to non-emergency services. Also, at the beginning of the year starting January 1st, 2017, you can’t be billed out-of-network charges for both emergency room and physician services.

This does not cover the 5.7 million people who are on employer-sponsored insurance plans however.


If you’re interested in learning more about what Stephanie can do for you, contact her directly at (949) 351-2443. If you need help with the next stage in your life or have any questions about insurance, you can count on Stephanie to point you in the right direction.