Group Health Question--FL

Jun 6, 2007

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  1. blaze1x
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    blaze1x Super Genius

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    Today I was sitting in a sales/training meeting for Individual Health Insurance and we're going through underwriting. I realize that I would more than likely be declined or have potential problems should a major illness befall me some time down the line. So I'm scrambling to figure out what I would do. My wife is a minister and covered under a BCBS plan. She could add the rest of her family (my son, currently covered under a state-issued policy and myself), for $8,000 per year. We can't afford that yet. I'm sure Insurance will be good to me, but it hasn't been that good where I can come up with 8k. So that got me wondering...what recourse do I have and what about declaring my family a group? I know the obvious thing to do would be to just suck it up and come up with the 8k when and if I get it, but it would be good to know all my choices.

    Thanks in advance for the advice.
     
    blaze1x, Jun 6, 2007
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  2. somarco
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    somarco GA Medicare Expert

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    Not sure if we have a FL group expert online any more. Since Paul (moonlight & margarita) was run off the only way to get good info is to contact him direct (which I do from time to time).

    In most states, and probably FL too, you need 2 full time employees on the payroll. That means 30 hours per week at minimum wage. Beyond that, not much else is required . . . other than the ability to pay the premiums.

    Group carriers are required to cover everyone regardless of p-x conditions. If you have creditable coverage there is no wait on p-x. If you opt for an HMO it does not matter if you have creditable coverage or not.

    FL is a very disjointed market with lot's of HMO's operating in certain zips. AvMed is still one of the better ones.

    That's about all I can say with some degree of certainty. When I worked the FL market I didn't handle anything under 100 lives and most of my accounts were 300+.
     
    somarco, Jun 6, 2007
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  3. TriDad
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    TriDad Expert

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    sorry for the delay in reading/replying to this thread. I've been working the Florida small group health insurance market for the past 13 years, and may have some useful info:

    FL carriers are required to write 1-man groups, but they make it very difficult. Agents are not compensated at all, so you won't find any help in the open market. 2+ employee groups can be issued year round, but most carriers won't pay commission worth mentioning unless you have at least 4 or 5 employees enrolling.

    1-man group plans must be apply during the month of August with an October 1st effective date. I recommend contacting the carrier directly to get started. If you know which carrier you want to go with, PM me and I'll send you their contact info.

    The plans offered aren't that great, because everyone knows why someone would be trying to get a 1-man group-------because they're uninsurable!!!

    I'd first find out if you truly are "uninsurable" in the individual market. Some carriers are becoming more flexible and may exclude a condition rather than flat out decline someone.
     
    TriDad, Jul 2, 2007
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  4. newmindfashion
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    newmindfashion Guru

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    Blaze,
    I would take advantage of TriDad's offer for some feedback. I know Aetna's underwriting seems very lenient right now.

    Also, the agent that Somarco was referring to, also knew his stuff. I actually paid him a consultant's fee to have him teach me the ins and outs of the individual market there and it helped a great deal.

    Although I may be remembering this wrong, one of the things I believe he told me was that BC/BS of FL would accept groups of 1 all year round and not just at certain times. However, apparently BC/BS of FL makes it difficult with long hold times and slow response.
     
  5. blaze1x
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    blaze1x Super Genius

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    Thanks for the response guys. Better late than never. As usual, I am once again happy to be a member of this forum.
     
    blaze1x, Jul 27, 2007
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