An Open Letter To Insurance Executive Lurkers.....

[annon123]

It's possible it's not asked in your state. They ask in NC, OH (my 2 main states) and several others.

Which state are you in or what state did you take an app in where UHC did not ask about Cancer?

MS

 

[sshafran]

MS

UHC in MS

Applicants that are outside of their Open Enrollment and do not qualify for guaranteed issue are underwritten for eligibility and they will be denied coverage if any of the following applies except for the first scenario (see note):

● Within the past 2 years, did a medical professional provide treatment or advice to you for any problems with your kidneys other than kidney stones? (Note: Not auto denied but additional information will be requested if "Yes". Enrollment Department will reach out to consumer)
● Were you hospitalized as an inpatient (not including overnight Outpatient observation):
● Within the past 90 days or
● 3 or more times within the past 2 years
● Are you confined to a bed, receiving home health care, or currently being treated or living in any type of nursing facility other than an assisted living facility?
● Within the past 2 years, did you receive IV infusions or injections for Primary Immunodeficiency Syndrome?
● Has a medical professional ever told you that you have End-Stage Renal (Kidney) Disease (ESRD) or that you may or will require dialysis?
● Within the past 5 years, were you diagnosed with, treated, given medical advice, or prescribed medications by a medical professional for Leukemia, Lymphoma or Multiple Myeloma?
● Within the past 3 years, were you diagnosed with, treated, given medical advice, or prescribed medications by a medical professional for Cancer (other than Leukemia, Lymphoma, or Multiple Myeloma) or Melanoma or Metastatic Merkel Cell (but not other skin cancers)?
● Within the past year, did a medical professional tell you that you may need any of the following that has NOT been completed:
● Any surgery, biopsy, further evaluation, treatment, or diagnostic testing?
● Are you awaiting any diagnostic test results?

The level 2 price question are ....
Within the past 2 years, were you diagnosed, treated, given medical advice, or prescribed medications/refills by a medical professional for any of the following conditions?

- Atrial Fibrillation or Flutter (AFib)
- Artery or Vein Blockage
- Peripheral Vascular Disease (PVD)
- Cardiomyopathy
- Congestive Heart Failure (CHF)
- Coronary Artery Disease (CAD)
- Chronic Obstructive Pulmonary Disease (COPD)
- Emphysema
- Chronic Kidney Disease
- Diabetes (but only if you have circulation problems or Retinopathy)
- Cancer, including Melanoma (but not other skin cancers), Leukemia and Lymphoma
- Cirrhosis of the Liver or a Heart Attack
- Macular Degeneration (wet form)
- Multiple Sclerosis
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus (SLE)
- Stroke
- Transient Ischemic Attack (TIA)
- Mini-Stroke

 

[straightnochaser]

Misinformation? Unless it has changed since last week the medical underwriting form I just filled out for a client for AARP UHC did not include asking about cancer. Some do, but UHC is less picky than some of them are which is fortunate for clients with issues who want out of a MAP and want supp G or F (if they are eligible) due to expensive health problems. Hopefully before you tell clients they will fail medical underwriting and are stuck in a MAP or on the supplement they have and want to change what they have, you will actually look at the current forms.

You can continue to trash me all you want. Doing that says more about you than it says about me. If you need to do that to make yourself feel superior/better about yourself then feel free to continue. It doesn't affect my life/me.

yikes

 

[sshafran]

I am surprised, for example, that UHC doesn't ask about cancer

They ask about cancer. Where did you get the idea they didn't? Same place as the idea about the Cleveland clinic?

I feel bad for the misinformation you give your clients.

Misinformation? Unless it has changed since last week the medical underwriting form I just filled out for a client for AARP UHC did not include asking about cancer. Some do, but UHC is less picky than some of them are which is fortunate for clients with issues who want out of a MAP and want supp G or F (if they are eligible) due to expensive health problems. Hopefully before you tell clients they will fail medical underwriting and are stuck in a MAP or on the supplement they have and want to change what they have, you will actually look at the current forms.

MS

UHC in MS

Applicants that are outside of their Open Enrollment and do not qualify for guaranteed issue are underwritten for eligibility and they will be denied coverage if any of the following applies except for the first scenario (see note):

● Within the past 3 years, were you diagnosed with, treated, given medical advice, or prescribed medications by a medical professional for Cancer (other than Leukemia, Lymphoma, or Multiple Myeloma) or Melanoma or Metastatic Merkel Cell (but not other skin cancers)?


The level 2 price question are ....
Within the past 2 years, were you diagnosed, treated, given medical advice, or prescribed medications/refills by a medical professional for any of the following conditions?

- Cancer, including Melanoma (but not other skin cancers), Leukemia and Lymphoma

Just making it easier for the agents in the room.

 

[annon123]

UHC in MS

Yes that is the same form I filled out for him. His was long enough ago he could check no, some forms are longer than 2 years ago though for solid tumors and my understanding is (haven't done one personally, just when I asked someone who had done a lot) that some count even routine check ups annually, even when they are and continue to be in remission, as being treated, seen, etc.

 

[sshafran]

Yes that is the same form I filled out for him. His was long enough ago he could check no, some forms are longer than 2 years ago though for solid tumors and my understanding is (haven't done one personally, just when I asked someone who had done a lot) that some count even routine check ups annually, even when they are and continue to be in remission, as being treated, seen, etc.

Ok, you're just trolling the forum.

You literally said, "UHC doesn't ask about Cancer."

 

[rmhaire]

Ok, you're just trolling the forum.

You literally said, "UHC doesn't ask about Cancer."

How does what he posted make him a forum troll.

It appears to me that you're the one doing the trolling.

Let it go and sit your ass down.

 

[straightnochaser]

This guy^^ smh

 

[sshafran]

How does what he posted make him a forum troll.

Read what he said in the context of the thread.

See post #54.

 

[renee15]

I think it's safe to say that this has been the most chaotic year of insurance for us all.....insurers and agents/brokers, alike. Many regulations and laws were passed that have harmed both of us.

Many of these regulations and laws, we know, don't make a lot of sense, and are going to cause much damage to the industry and our clients. Essentially, I think it's safe to say that we have all been divided in our own self-interests, as well....forcefully, and to no fault of our own, due to these changes.

As an agent/broker, I think I can safely speak for pretty much everyone here when I say that a LOT of damage has been done that's going to be very hard to repair. Almost all trust is gone, from our perspective. BUT, that doesn't mean you can't start re-building this trust, and this very vital relationship you have with brokers.

I believe a lot of companies panicked and just started making cuts to whatever, wherever. This is not good for the longevity and vitality of your business, as it MASSIVELY hurts your reputation among us agents and the clients.

Some companies were obviously damaged much more than others. WellCare.....all I have to say is, an immense amount of good luck to you long-term, because you're definitely going to need it.

For the other insurers, you can redeem yourselves. WellCare, unfortunately for them, made the very stupid decision to steal our earned renewals, which we worked tirelessly and immensely hard over the years to earn.

This is shortsighted, and very unintelligent. The damage they have done to their own company will take a generation to recover from. A few other insurers chose to cut future commissions on many plans, while also simultaneously cancelling popular plans and not cross-walking these clients of ours to other plans they have available.

This also is a major slap in the face to us agents, as this is almost the same thing as stealing from us. As agents/brokers, we take your mandatory ethics class sections, and we now laugh in disgust, as you are no one to be preaching ethics to us. This is just where we're at.

As President Donald J. Trump has now just been chosen as the President Elect, again, I predict a lot of stability and money is going to come flowing back into the industry, but please understand that we will not be forgetting who did what to us. My recommendations going forward would be pledges to release plans that ALL pay commissions, always.

If you don't really want people on a plan, then don't offer it. Simple. When you put plans out, and then don't offer agent pay, a HUGE red alarm goes off in our heads and we then don't trust you at all. We start to think you're probably going to make this a regular thing, and we don't know if you will choose to do this to plans that we have many people on.

Another recommendation would be, if you are going to cancel a plan, then AUTOMATICALLY crosswalk these people into the next best plan you have. We agents/brokers work tirelessly long hours. I'm on my 15th work hour today.......on a Saturday.

We do not have time to be going out to all of these people to simply change them from one plan to another plan, simply because you chose to end the plan. We work hard to BUILD UP business, and we do not appreciate having it torn down literally overnight. Crosswalking protections need to be in place.

Finally, pledges in writing to never steal our previous earned renewals would be the absolute most important thing. This business is built upon trust, and this is the ultimate betrayal to us. No matter which way you cut it, it's theft.

If you're having trouble, we all know you can raise a small copay here or there to pay for it. There are many things you can do to work around monetary challenges. Theft is NEVER an excuse. We are doing a very important job for you and we have to be paid. Period.

Like us or not, you need us to drive in sales and to retain these folks. These people trust us like family, and we can turn almost an entire book of business over to a new company in a month. I don't say that as a threat, simply as a matter of fact.

I will also extend an olive branch, and I will say that I understand the government was a major cause of a lot of this chaos, but you should have just worked with us, not panicked, and not started yanking commissions away from us. Sit down in good faith and speak to us and negotiate with us. That's all we ask. These decisions that many insurers made were EXTREMELY short-sighted.

I understand there will always be some challenges in the industry, if new administrations come in that are not exactly friendly to insurance, like Biden/Kamala, but we have to work TOGETHER to overcome them.

This is a total cohesive team, or at least it should be......insurance companies, FMO's, agents/brokers, etc. Our goals are all the same....to help our client stay happy/well-insured and to make money.

Part of being a good executive is the ability to think ahead. We should have a lot of stability for at least the next 5-6 years or so. Make some adjustments in the anticipation of a future administration that may not be so friendly to us, in order to stay ahead of the game, monetarily.

I think all the insurance companies, agents, and FMO's should also be lobbying the government hard for some major changes to star ratings. Many areas of star ratings are extremely good and vital to make sure the plans are still accountable and doing right by the client.

However, I was recently made aware that one company lost an enormous amount of money because literally 2 calls were dropped and because one of their reps had a very hard time understanding a secret shopper who was faintly screaming in another language, and they didn't know what interpreter to try and get for them.

This kind of clown world nonsense needs to end. Dings like this cost the companies an immense amount of penalty money, and in-turn, there is less money to go around to the companies, in order to pay us our wages, and to bolster the plans to make them better for seniors.

I thank you for your time, and I hope the future steps you take will solidify our relationship going forward. Please understand that from here on out we will be watching every step very closely, as this has been a huge wake-up call to us all, but we have to take steps to rebuild what has been torn down the past 4 years.

Trump wants to shut down the ACA which will cost agents $. He isn't on your side.