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What are the POSITIVE reasons for enrolling someone in Ambetter Celtic Chicago? The lack of hospitals keeps me from being interested in any aspect of this company.
Ambetter Insured by Celtic?
- Thread starter Pancur
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Good question especially for 2017th enrollment. They probably will increase their premiums, and cut the clients' reason to be with them. I have many people their and not sure if will be appointed.
I had several phone calls during the year, from people that applied for a policy either by themselves online or through a navigator, crying that they cannot go to a doctor and want to switch the plan.
As for me, I will only do it for people who want to avoid paying the penalty, and they either don't have to pay anything (fully subsidized) or only few bucks. I explain them precisely "You are not paying for the plan, so don't treat as a health insurance, this is only for you to avoid paying the fine", many people still hate "Obamacare" and treat is as a necessary evil.
Regarding AmBetter, I guess it is a smart move on their behalf, since they will get most of the healthy and young people who want to pay less.
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Those are reasonable reasons for selecting Ambetter-Celtic, Prencik. Do you know if the company is paying commissions, and/or if New Agent Appointments are being accepted?
I contracted with them before 2016 OEP, so I'm not sure what they are doing to do this year with new agents. We had a few phone calls from them during the year, asking other agents in our office to sign a contract with them, but I think that one agent is enough.
In 2015 AmBetter was really close with BCBCIL for the silver plans. When rates reviews for 2016 were published on hc.gov, Blue Cross the cheapest HMO went up 29% (didn't know how Blue Care Direct will compare since it was a new plan). AmBetter was not on the rates review list, so I figured that they are not going to rise prices more than 10%. And I expected that some clients were going to ask; what is that cheap plan, and yes I want it because I don't need insurance, although I wrote only a handful of their policies, majority of my clients, after a careful explanation picked more reliable options. The majority of policies I got were actually from people who first talked to navigators, they always pick the cheapest plan. It was not even a hard sale, people really appreciate that I explained what they are getting, and they like to talk to a one, same person, who actually knows something about plans. Once I explained the company and the plan, and they were still OK with that, I asked if they wish for me to be their AOR, everyone was happy with this.
I was very skeptic about it, but as for paying commissions, they pay fair and square. When I checked my commission statements, only LLH and them, paid every single dime. I cannot say the same about Blue Cross.
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Good question especially for 2017th enrollment. They probably will increase their premiums, and cut the clients' reason to be with them. I have many people their and not sure if will be appointed.
Yes, they are rising prices around 20%, you can check that on hc.gov. But the gap between them and Blue Cross will be at least the same, if not greater. For people who get the subsidy it will be hard to swallow.
- 8,448
Thank-you for that through and useful information regarding your Celtic-Ambetter experience, Prencik.
When Celtic was just "Celtic Insurance Company", they often had the least expensive IFPlans in Cook county. Underwriting was inconsistent, but it was far more lenient than Blue Cross was.
I'm glad to hear that Ambetter is reliable when it comes to paying agents. That is one bright spot for them. If they're going up 20% and Blue Cross 50%, the premium gap between the two will be even wider for 2017. This will also make the Cook county APTC/Subsidy lower in Cook county. That was a big problem for 2016. Cook county residents received a 30% lower subsidy than those in the Chicago collar counties.
I'd like to have more carriers for my Kane, Lake, DuPage clients, but honestly, I'm glad that Ambetter isn't one of them. We'll just have to tough it out with Blue Cross. It seems that the Health Alliance company has bailed from the Marketplace too. It was available for Rural residents, though I never contracted with them, due to so much bad publicity.
When Celtic was just "Celtic Insurance Company", they often had the least expensive IFPlans in Cook county. Underwriting was inconsistent, but it was far more lenient than Blue Cross was.
I'm glad to hear that Ambetter is reliable when it comes to paying agents. That is one bright spot for them. If they're going up 20% and Blue Cross 50%, the premium gap between the two will be even wider for 2017. This will also make the Cook county APTC/Subsidy lower in Cook county. That was a big problem for 2016. Cook county residents received a 30% lower subsidy than those in the Chicago collar counties.
I'd like to have more carriers for my Kane, Lake, DuPage clients, but honestly, I'm glad that Ambetter isn't one of them. We'll just have to tough it out with Blue Cross. It seems that the Health Alliance company has bailed from the Marketplace too. It was available for Rural residents, though I never contracted with them, due to so much bad publicity.
Rates for BlueCare Direct are going up 23% according to rate filligs. AmBetter either 22% or 18%. That should keep those plans close to this year difference. Blue Precision 25%, which is still close, and subsidies might keep them relatively similar to what we have now. BlueChoice PPO will be unattainable for people with low income.
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- #28
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I had a young client die this year because Blue Cross wouldn't cover her in the hospital where she needed treatment. (Some kind of toxic shellfish shock)
She was in University of Chicago hospital on the Blue Precision HMO, and in a coma. She needed to be transferred to another Chicago hospital, where they specialize in treating this condition. (Can't recall the name now.)
For that reason, I stay far way from the Blue Care direct plans, as well as Celtic-Ambetter. With those plans, the vast majority of Chicago hospitals would not be covered, if a transfer to one of them was desired/needed.
Naturally the words "not allowed" only apply to people who must use the insurance coverage. If they have the financial means, they can transfer to any hospital that is suitable for treatment of the condition.
It's is horrible, it is supposed to be "the greatest country on the earth", and people cannot get decent coverage, even though we have the best technology, treatment options, and the doctors.
I have a few clients with BlueChoice PPO that were hit with tens of thousands of dollars with balance billing especially from Advocate Group for emergency stay, with HMO everything was covered, even though they were OON. Sometimes the PCP needed to sign some additional refferals, but in this type of situation, from my experience HMO was better. On the other hand, people with some rare chronic condition are definitely in a really bad position.
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