- Thread starter
- #11
group for insurance agent
- Thread starter johnrocks
- Start date
- 14,808
No one thinks you're trying to cheat the system. You deserve to have coverage and you're willing to pay for it. Just make sure you cross all you t's and dot your i's - that's all.
- 1,183
2800? That must have included some kind of test or something and not just seeing the doctor. The case I was thinking of was where my g/f went to charity and paid $300+ for some kind of shot to help her with her flu and seeing a doctor and I figure she probably could have saved $100 or more at one of the private hospital's "minor care" facility with half the wait.
G
Guest
Guest
In CA, it's done all the time. If 5 cancer patients start a busness, especially a corporation (easy to do), set up a payroll system, an accounting system and can show that they are actively working to make a profit (doing marketing, selling products, showing a cash-flow (either negative or positive), a carrier in this state would be hard-pressed to deny them claims made after necesssary waiting periods. And I don't know how the carriers in MD could either... but I don't live there.
There are no shortage of lawyers in the state who give advice on how to do all the above. Do I recommend that people do it? No. Why? Because I'm sure that if an agent was caught by one of the larger players giving that kind of advice, they would lose their appointment, or perhaps their license.
When I'm asked by a someone (say a husband or a wife) about whether or not starting a new biz and getting group would cover them, I tell them to see a lawyer about AB1672.
Our own Dave Fluker has it all on his site:
http://www.davefluker.com/newgroup.html
Al
I do not know what pre-existing medical conditions you might have that would prohibit you from getting coverage, but if the only thing holding you back is your weight, have you thought about losing weight in order to qualify for individual health coverage before some serious happens? I recall you posting on another forum about what some people have done to lose weight, so I take it that is a concern of yours.
-J.R.
- 112
Not to discourage you, but most companies will treat massive weight loss as large a risk as being overweight, if not more.
I would suggest though that you follow a gradual decrease in food intake and a gradual increase in exercise, you can find any system out there and probably make it work for you if you truly work at it, but that's the basice rule of thumb.
I'm sure you have heard about all the risks of being overweight, so I won't throw em' at ya, but all the wealth in the world doesn't matter if you don't have your health.
Start walking about a mile a few times a week, once you drop some, walk some more. Start lifting weights at that point, muscle burns fat while you doing nothing, so the more muscle you put on your body, the more efficiant your body will be.
At this point, you should be only 30-40 lbs over your target weight, you have been walking a lot, lifting weights, learning how to eat right, eliminating any bad habits you may or may not have during the day.
Start running then, start slow and increase it, soon you will have no choice but to become a lean, mean insurance selling machine.
Case in point, show me someone who has been putting in 8-12 miles a week, and is still chronically overweight...chances are you can't.
Some some pointers...I hope you won't get offended by my advice or anyone else's here.
We're just trying to look out for you here!
Your state DOI site may or may not provide the information you need. Some sites are good, some are not. My suggestion is to call the DOI or call a small group carrier. They can tell you what the requirements are.
Start with BX.
Most carriers will want payroll records, at least 3 - 6 months worth to show you are a legitimate company. Profit is not an issue. Amazon operated for years at a loss. So has Delta. The IRS does require you show that you are ATTEMPTING to earn a profit, but there are no profit requirements in the law.
The risk pool, if LA has one, may be expensive but so is incurring a large claim without insurance. Providers will find a way to get their money. Paying back a large claim thru forfeited assets and garnished wages is a lot more expensive than paying for insurance (including COBRA, conversion & risk pool) premiums.
Start with BX.
Most carriers will want payroll records, at least 3 - 6 months worth to show you are a legitimate company. Profit is not an issue. Amazon operated for years at a loss. So has Delta. The IRS does require you show that you are ATTEMPTING to earn a profit, but there are no profit requirements in the law.
The risk pool, if LA has one, may be expensive but so is incurring a large claim without insurance. Providers will find a way to get their money. Paying back a large claim thru forfeited assets and garnished wages is a lot more expensive than paying for insurance (including COBRA, conversion & risk pool) premiums.
- 14,808
It's an extreme example but if 5 uninsured cancer patients did indeed get together and form a company just to obtain coverage the second all five went to file claims they'd have their coverage rescinded. That's an attempt to defraud the insurance company and a very small investigation by the insurance company would easily proove that. And you're right - if you recommended that kiss your appointment goodbye.
G
Guest
Guest
The keywords here are just to obtain. If the five cancer patients followed all the procedures (incorporation, biz license, taxes, payroll, etc.) and can show marketing and sales activity and cash flow (either in or out, positive or negative) I'd like to meet the insurance carrier lawyer that can convince an administrative law judge that this group is committing fraud.
Oh yeah... they may be... but I'd like to hear the argument and see the evidence that the carrier would present. Why? Because I think that even Bozo the Clown with a law degree from a 2-day corresponsence school in Botswana could easily defend this.
I'm told that groups are formed everyday under CA AB1672 just FOR the purpose of getting insurance. I'm also told "Why do you think group rates are so high in CA?" I personally don't know of any such groups, but I know what I hear.
Al
The rule of law that applies here will more often than not come into play were there are dissimilar groups of individuals or companies. If a butcher, a baker & a candelstick maker all decided to form a group to get health insurance it most likely would not be allowed.
There are no common business interests.
There is no common ownership of the businesses.
There appears to be no other function from this group other than obtaining health insurance.
But if a group of butcher formed a co-op to promote the benefits of eating meat and attempt to collectively negotiate lower wholesale pricing for their product and advertising, then it can be argued that the health insurance was incidental to the formation of the butchers co-op.
There are no common business interests.
There is no common ownership of the businesses.
There appears to be no other function from this group other than obtaining health insurance.
But if a group of butcher formed a co-op to promote the benefits of eating meat and attempt to collectively negotiate lower wholesale pricing for their product and advertising, then it can be argued that the health insurance was incidental to the formation of the butchers co-op.
