Celtic

[Guest]

Maybe you pissed-off Aetna and they have targeted all YOUR clients

That would be illegal.

And a major healthcare carrier (or P&C) would care about that... why?

You really think any DOI would kick a MAJOR carrier out of their state?

It's an 'antelope dance' between the DOI and the majors. The DOI wants to look 'strong' ... that they are protecting the public and the carriers are happy to play along... so long as the DOI is not doing anything substantive. There is a balance (somewhat) between them (at least in CA) and the carriers know that they can buy and sell the legislature on any given day of the week, at least on most issues.

And while the carriers come in for their share of the 'blame' the DOI regs can be just as unreasonable in their actions and decisions.

I write healhtcare but when I see the arrogance of both the carriers and the DOI staff... and the fact that they are both playing games... but in the name of 'the people' I sometimes feel "A pox on both your houses" and support a one-payor system (CMS?) and let's start over.

Remember one thing and one thing only. When it comes to the DOI and the carriers and the legislature, its all about the money. Not good healthcare, not the interest of the citizens, and not the interest of the business community. Follow where the money will go and you can figure out what the policy will be.

Am I a cynical? Is the Pope Catholic?

Al

 

[J.R.]

Every company but Assurant has turned me down saying that I cannot obtain any specific documentation

Really?

So you have been able to get a copy of a specimen Right Start policy? That is the only one I cannot get.

Yep, I am appointed with every major carrier in MD, with the exception of Celtic and every company rep (Assurant Aside) has told me the same thing. "We do not provide access to sample contracts and the only way to obtain one is to sign up an applicant and get a copy." It is not a big issue with me because Assurant is competitive in the area, but having to ask a client for a copy of their plan doesn't really build credibility and respect if you know what I mean about the insurance carrier, nor is it the image I wish my agency to represent. Granted, I do not think it is prudent to go over every detail of the specimen contract with a client, but if they have a question, I either want to have it memorized or have a document that I can reference.

I do not sell any plan with Right in the name, so I have not bothered to obtain a specimen contract. Max, CoreMed or a HSA is all I ever discuss. If they want the basic coverage and cannot validate or afford the extra $25-$75 it costs to upgrade to a CoreMed from a Right Start plan than I do not want them as clients because I do not want to run the risk of hurting them financially because I sold a limited plan with crappy coverage. Please bear in mind that I deal primarily with small business owners. College Students, recent legal immigrants, etc. might be a great fit for the Right Start Plan, however, I do not target that demographic so it is not important to me and there is always STM for the aforementioned groups depending upon the circumstances. In the odd situation that I "have to" sell a Right Start plan, I will have to consult a lawyer to draft up a document to protect the interest of my agency. If that comment doesn't strike home with the prospective client then they can get a second opinion and call me when they make a decision.

 

[somarco]

i have a right start policy in a box that i got about a year ago...think i got it from a client....

That is the only place you will get it.

I have asked Time for a specimen policy, and they refused. It isn't in their back office to download like the other plans (Core Med, Max, One Deductible). Don't you find that a bit curious?

it say its a "major medical" now thats a loose use of the word by assurant

Are you suggesting the word "minor" might be more appropriate?

 

[somarco]

And a major healthcare carrier (or P&C) would care about that... why?

Gee, I dunno. How about major adverse publicity when the DOI lays down a heavy fine and the 6 o'clock news get's hold of it?

It may be different in your state, but we have an elected Insurance Commissioner that likes his face on the news, especially in an election year, for being shown as a crusader for the little guy.

Last year when BX failed to successfully negotiate a renewal of their HMO contract with one of the major hospitals, the local news & the IC were hot & heavy on the story. Finally Blue admitted they were only kidding and came back with a more reasonable contract after forcing their HMO patients served by Piedmont hospital (and related providers) to look elsewhere for almost 2 months.

Am I a cynical?

Yes.

And a bit green.

But that's OK. We love you any way.

 

[Crabcake Johnny]

Just don't sell it and you won't have any worries. A lot of agents mistakenly think people want cheap insurance. They do if that's how you sell it. When I talk about insurance to prospective clients I say things like "comprehensive" and "A great value for the rate." People don't want "cheap" anything. And if you think people buy based on price you'd better pay attention to how people shop. They buy the most expensive item that fits into their budget - not the cheapest, or we'd all be driving Cavaliers.

When I sell Assurant 100% of my business now is between the Max and HSA. Yet I talk to other agents who claim they can't sell a Max or HSA to save their life - all they sell is CoreMed and Right Start. It due to fear of the client saying no due to the price when you haven't built any value into the product nor talked about potential liability.

I have a question that makes most of my clients laugh:

"So do you want a plan where you'll be slammed with bills if you have a major event or a plan that'll just pay them?" Most laugh and I say "Then don't look at the CoreMed or anything with "Right" in it.

I'd rather sell a $5,000 deductible Max then a $2,000 deductible CoreMed.

 

[somarco]

every company rep (Assurant Aside) has told me the same thing. "We do not provide access to sample contracts

I have spec contracts from KP & BX . . . only because I asked.

World, Time (except for the Right Start) have them available for download. Didn't need to ask for GR because the first one I sold had to be changed after it was issued so I kept the original and had the corrected version sent to the poliyholder.

upgrade to a CoreMed

Either MD doesn't have the same Rx benefit as GA ($25 + 50%) or you fail to understand just how big of a hole that can leave in a clients bank account when they really need it.

 

[somarco]

100% of my business now is between the Max and HSA

Thought I had posed this before. Maybe not.

Does the Max plan in MD have a $25 + 20% Rx benefit like in GA or not?

 

[Crabcake Johnny]

It does. Here are RX options in MD:

Aetna: $5,000 cap

Golden Rule: $30 or $60 copay - neither here nor there for clients on meds since they get ridered out.

Optimum Choice: $3,000 cap

Carefirst: $5,000 - $1,000 - $1,500 cap

Kaiser: $1,750 cap

Assurant: HSA - paid after deductible - Max $25 + 20% - CoreMed $25 + 50%

Pick your poison.

 

[somarco]

Looks like GR and Time One Deductible are the only safe choices.

 

[Crabcake Johnny]

Only half the picture. Underwriting is the other half. When someone's on expensive meds that Assurant and GR gonna rider then I'm off to Aetna. GR riders out meds if anyone's on any meds. At least Assurant has the flexability to raise the drug deductible and at least offer coverage - GR just terrorizes them.

How 'bout 60 male and 60 female smokers who don't have a lot of money and are both on high blood pressure meds? Then I'm off to Carefirst Personal Comp with only a $500 cap but who cares if they can't afford the $600+ a month Aetna, GR and Assurant want?