Ethics Question
- Thread starter dgoldenz
- Start date
- 9,744
Are you sure?
It's been a couple of years, but I think I recall reading (The New Health Insurance Solution) that HIPAA eligibility can differ between owners and employees to address just such a scenario.
Sorry it's a little vague due to elapsed time, but I would think you would want to check to make sure...
- Thread starter
- #13
Interesting, good website, will have to bookmark that one.
No, I am not 100% sure, but I do recall having a group before that was a group of two owner-employees that dropped the group and were eligible for HIPAA since there was no COBRA option. I will double-check to make sure before doing anything, of course.
- 4,096
This group is turning into a lot of work.
Why not just submit the applications for a pre screen?
Lock the rates in and then go from there.
On a Mom and Pop group its very important that they have the payroll in place not just now but in the future. Because a group like this could get an audit by the carrier you put them with.
IN VA is there some type of HIPPA/Cobra or high risk pool plan?
Now from the carrier standpoint you will not get any favor points because they know what you are doing. Even though you work for the client you still have to do business with the carrier.
I would walk a way
Why not just submit the applications for a pre screen?
Lock the rates in and then go from there.
On a Mom and Pop group its very important that they have the payroll in place not just now but in the future. Because a group like this could get an audit by the carrier you put them with.
IN VA is there some type of HIPPA/Cobra or high risk pool plan?
Now from the carrier standpoint you will not get any favor points because they know what you are doing. Even though you work for the client you still have to do business with the carrier.
I would walk a way
- 1,896
DOI regs here: max rate-up of 67%, but still group GI. The rate-up hurts both the group and the carrier, so no one wins - but both lose.
I used to have a conscience when it came to dealing with carriers but I got over it. As far as small group is concerned, the carrier has the right to get in that market or not. If they jump in, they should anticipate adverse selection. If they don't like it, or price for it, that is their problem.
Aetna seems to try harder than anyone to not write a small group. Payroll records, no 1099, the way they calculate participation, all of it makes it almost impossible to write a group less than 5.
Even still, I do have a few groups with them.
I don't think I have a single group with less than 5 employees that is not running a negative loss ratio, but then, that is not my problem.
