HealthFirst Decision Tree

“Start with the best solution. Only move down when the client forces you to.”

Client Name

Questions answered0 / 11

Client Qualifiers

Under 65?

Client's age is below 65

Generally insurable?

No major uninsurable conditions (AIDS, cancer, organ transplant, etc.)

Actively seeking coverage?

Client is ready to enroll

Coverage Needs

Needs maternity?

Client or spouse needs maternity coverage

Needs mental health?

Any member needs mental health coverage

Health Profile

Diabetic on >2 meds?

Has diabetes AND is on more than 2 medications

Has asthma?

Any member has an asthma diagnosis

Sleep apnea?

Often undisclosed until application — flag for Manhattan review

No Manhattan knockouts triggered

TIER 1✓ RECOMMENDED

Manhattan — Package of Protection

Good fit for healthy clients under 65

Package: AFC Elite · Spec Disease 250k · 24hr Accident · HI Select 10k · DVH · Americo HMS125 · Living Benefits 50k

· Build OOP + HI to cover Spec Disease deductible
· Split age brackets when possible
· Asthma: no ER/hospital in 24 months, BMI < 25 required

Manhattan Life Agent Portal Americo HMS125 Rider

If Manhattan declines at underwriting, send the Milliman Suitability Tool before routing to IronHealth.

Backup Plans

TIER 1

Manhattan — Affordable Choice

Same-carrier value bundle when POP premium is a stretch

· Present when client wants Manhattan but pushes back on POP price
· Review essential benefits vs exclusions before quoting

Manhattan Life Agent Portal

TIER 1

Manhattan — MH Blue Ribbon

Alternate Manhattan health path — compare network and riders

· Use as Good tier when staying on Manhattan carrier

Manhattan Life Agent Portal

Plan Ladder

TIER 1Manhattan — Package of Protection▶ PRIMARY

TIER 1Manhattan — Affordable Choice

TIER 1Manhattan — MH Blue Ribbon

TIER 2IronHealth — PSM Thrive PPO $2,500

TIER 2IronHealth — PSM MaxGuard

TIER 3LifeX — $500 Co-Pay Plan

TIER 4USA Health (Cigna Triad) — $7,350 Deductible

TIER 5Last Resort — UHC Short-Term / Guaranteed Issue