Celtic

Am I a cynical?

Yes.

And a bit green.

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

Green? I don't know. I'm 60 years old (almost... 8 months away) and have been in biz for myself for 30 of those years and in the state capitol for 25 of those. The only 'green' I know about is the green that flows from the carriers pockets to the campaign committees of the legislature, the statewide offices, and various appointed people (free trips, meals, etc.)

Fines? Bad publicity? Not contracting with various providers? The largest carrier in CA has done been through all of that.... and they are bigger and wealthier than they've ever been before.

I'd rater be green... than naive.

Al
 
Peelerinsurance.com said:
been in biz for myself for 30 of those years and in the state capitol for 25 of those
.....

so you remember when celtic had a group plan in texas.....what happened....oh yea....they pulled out...with my trust....
 
Peelerinsurance.com said:
been in biz for myself for 30 of those years and in the state capitol for 25 of those
Geez Al... and to think I thought my 6 years in politics and public life was allot....... humm.....

Bad spellling. I meant state capital and not the physical building.... although I've have spent a lot of time under the dome in various jobs... but not as an elected anything. I just wanted to clear that up. (Started as a lobbyist in 1975... it's true... we had to register with the Sec. of State... you can look it up.)

When you live in a state capital, you are (or can quickly become) more aware of state issues than in other cities... if for no other reason than the fact the 'government' is the principle employer of the region such that many of your friends, colleagues and clients work for said government. The media carries more stories of issues, and people seem more intereted in state issues in general than in other
cities.

So when I say "follow the money" I know what I'm talking about... from long experience in working on campaigns to dealing with individual legislators. It was right here in CA (Sacramento) that the once famous Jess Unruh stated: "Money is the mother's milk of politics."

He also said (about lobbyists and legislature), and I heard it with my own ears: "If you can't take their money, drink their booze, eat their food, screw their women, and still look them in the eye and vote against them, you don't belong here."

I met him twice. Good man... well sort of! He was the one who held Sirhan Sirhan down after RFK was killed.

I told you I'm old!! I remember it like it was yesterday!

Al
 
been in biz for myself for 30 of those years and in the state capitol for 25 of those. The only 'green' I know about is the green that flows from the carriers pockets to the campaign committees of the legislature, the statewide offices, and various appointed people (free trips, meals, etc.)

My apology. Must have had you mixed up with someone else. Coulda sworn you have posted a bunch of negative crap about how the health insurance biz is going away.

I have heard that since I entered the biz full time in 1975 and guess what? It still keeps going. My only regret is that I left it a few years back and let my renewals slide.

I personally think this is the best time to be in the business, if you understand it. Didn't spend any time in politics, but I did have enough carrier time working closely with (but not physically in) the home office of several carriers & reinsurers. The mid to late 90's were wilder than anything of recent memory with carriers entering the market almost daily. New players came in, undercut the established players by 20%+ then quickly exited. This soft market lasted long enough to really screw up the industry for large group and individual. Many international reinsurers simply left the US market because it was so crazy and only a few have returned.

At least now there is some sense & predictability to the market. 10 yrs ago it was the wild west.

Locally, Blue has been a mess for some time and now with the Anthem connection they may finally get their act together. Of course they still have to pay for the sins of their past and that may take some time to shake out.

Right now the small group market is the only thing that is still messed up. All they get are the risks that can't go anywhere else so they write a plan and give the max rate up (at least in the 2 - 5 market). If I were a group carrier I wouldn't write anything less than 10 lives but no one asked me. The under 10 market is a money loser.

And despite your cries about lobbying money, etc the carriers still get slapped around in the press and it does hurt them.
 
Must have had you mixed up with someone else. Coulda sworn you have posted a bunch of negative crap about how the health insurance biz is going away.

I don't personally know anyone who seriously believes that the government can successfully run the system. And I don't know anyone who has a major problem with their PPO system... but I do know a lot of folks who are not happy with how their HMO runs... one of the reasons CA created a whole bureauracy (Dept. of Managed Care ... I worked there for a while) to deal with this one segment. (Virtually powreless... all flash, no cash... a whole agency built on blue smoke and mirrors if you know what I mean.)

The issue people have with the ins. carriers is that the costs are too high for the value received. (I'm not saying that.. I'm repeating it.) No one seems to make the connection between the cost of care, the usage of facilities, and the price of premiums. And yes the entire underwriting system is in need of an overhaul.

What I find that gets people really torched is the poor care they get in hospitals vs. what they get billed. I read one report that said you could stay in the Ritz Carlton with a private RN for less than some rooms at some hospitals.... and get better food!

This IS an exciting and interesting time to be in the healthcare field (not just insurance... but the clinical side and the policy side.) I look at it as being similar to being in the social work area in the mid 60s when the "Great Society" was being proposed and implemented. Hopefully our generation (those in their 50s and 60s now) will do a better job re-doing healthcare than our parents did with poverty and education.

I come to this biz after having done a lot of back-office implementation (computer system) of healthcare policy. I worked on one of the very first MMIS systems and later met my first, current, and very expensive wife when we both worked in Blue Shield in San Francisco in the mid 70s.

Since then I've done healtcare data processing for several state agencies (and you don't want to hear about the thousands of hours of mind-numbing meetings I attended on how we were going to automate the stupid policies the senior bureaucrats and legislature mandated. UCR alone is a nightmare!)

Everyone 'hates' the insurance industry. But this industry enables the entire economy. Nothing would move, no one would take any risk, no one would put their home, job, or savings on the line to coach little league, or hire a string quartet to play at a party, or ship a million dollars of wheat to Russia, or chance not getting sick or having an auto accident. Insurance is like the oil in the engine. Take it away and the pistons freeze up. "We" enable things to happen. Without 'us' there would not be a pot of moeny to fund new drugs and life saving diagnostic technology... unless the government funded it... and we know what a great job the bureaucrats can do!

Maybe a modern economy and heathcare system can run with risk mitigation, but I don't know how it would be done cheaper or better.

Yeah, I'm pissed at how some of the carriers operate... the greed and the waste... but that's the same for all industries. All I know is that most people who work hard for a living are not going to lose their home and hearth if they break both legs and can't work for 12 months. Is that going to happen in Cuba or Russia, or China?

They system IS broken, but it can be fixed. However, if they throw it out they damn well better have a good plan to put in its place.... or you are going to see a recession/depression like you've only read about in history books.

Just my opinion... and worth what it costs.

Al
http://www.InsuranceSolutions123.com
 
The issue people have with the ins. carriers is that the costs are too high for the value received. (I'm not saying that.. I'm repeating it.)

Then it becomes our job to educate them.

At least those willing to listen . . .

No one seems to make the connection between the cost of care, the usage of facilities, and the price of premiums.

That disconnect occurs when the one receiving the services is not the one paying. If meals were a $10 copay, whether you ate at McDonalds or a 5 star restaurant, guess what would happen?

McDonalds would go out of business, or at the least, cater only to those who were not "privileged" enough to have meal insurance.

What I find that gets people really torched is the poor care they get in hospitals vs. what they get billed. I read one report that said you could stay in the Ritz Carlton with a private RN for less than some rooms at some hospitals.... and get better food!

I don't recall ever seeing a trauma room at the Ritz or folks who got full service even if they had no money.

I'm pissed at how some of the carriers operate... the greed and the waste...

And the govt does a better job?

http://insureblog.blogspot.com/2007/03/in-future.html

Show me a system, anywhere, that is better than what we have here.
 
To the best of my knowledge here in Louisiana these are the only carriers available for indivual health BCBS World Celtic Assurant American National United American United Healthcare and their affiliates and Vantage health Plans which is a local Hmo that is coming out with an ind plan in July so I really don't have a lot of choice Maybe I am wrong about that I sell mainly to seniors but I was looking for a plan for myself as well as maybe going to a few business owners between appointments and try my hand in health

Humana is another option in Louisiana for individual health. Their individual plans are marketed as Humana One and they have a Major Medical PPO as well as HSA/HDHP plans. I have mainly focused on Medicare products and don't know a whole lot about the individual market but I understand Humana One is very competitive with BCBS in Louisiana. I really haven't gone after any individual business up until now and almost every prospect that I've had referred to me is uninsurable. One aspect of Humana's plans that I'm aware of is if the client elects the Dental option, if they have the medical plan for over 90 days and choose to cancel, they can keep the dental insurance.
 
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