**Health Insurance "Declines" On The Rise??**

AllenChicago

Guru
5000 Post Club
8,448
Suddenly I get two applications declined for individuals who requested a October 1st effective date. Coincidence? Could underwriters be under pressure from their finance overlords to be extra stingy due to all the new mandates coming?

Aetna: Turned down a 52 year old female who takes a pill for diabetes..since 2002. No other adverse health issues or history. Prior to this, I could always count on good old Aetna to insure middle-aged Type II diabetics on a $5,000 deductible plan.

Celtic: Turned down a 56 year old female who has her Cholesterol and Hypertension controlled with medication. No other negative health factors. Celtic has always EASILY approved these applicants (and worse..) over the past 2 years that I've worked with them. In fact, the reason I contracted with Celtic is because people who were turned down by the "BIG BOYS" were approved by Celtic. They had riders and rate-ups, but they were never declined.

If any of you begin to see a pattern like this with your applicants for 10/1/10 or later, please post your experience and observations in this thread. Thanks in advance.
-Allen
 
KP is the only carrier here that has released rates & plans for 10/1, so hard to say. FWIW, lately H1 has been shooting out approvals like a welfare queen shoots out babies.

Aetna has been a hard ass on underwriting for the last 4 months. I can almost always find a reason to direct business elsewhere.

Celtic is a non-player in the GA market except in Dalton where, for some reason, they have more par providers than BX.
 
Celtic rocks. The best 3rd world carrier to ever sell medical insurance ever.

The company that now owns Celtic (Centene, Corp.) earned $3.8 Billion and broke into the Fortune 500 in 2009 by administering Managed-Care plans for Medicaid. I wonder how you can earn that much money administering programs for the poor? Must be a lucrative pipeline from the US Treasury..LOL.
-AC
 
Diabetes? HBP and CHOL ?

These are challenging cases to place long before health reform.

Your second case might get issued with BCBS IL...
 
how you can earn that much money administering programs for the poor?

Medicare & Medicaid claims are administered on a cost plus basis and it is quite lucrative. Same for Tri-Care.
 
Diabetes? HBP and CHOL ?

These are challenging cases to place long before health reform.

Your second case might get issued with BCBS IL...

I've never had Celtic turn down a person with a BP/CHOL combination, but after I talk to the company in the morning, I'll have a better idea as to why. It could be because this lady was diagnosed fairly recently... in January 2010. If it's as simply as that, I will give BC/BS-IL a try. Thanks!

Aetna turning down a long-term typeII Diabetic is a real surprise though. Applicants with her profile have always been accepted by them, albeit with very limited Diabetes coverage. I'll suggest the new Pre-Existing Condition pool to her.
-AC
 
Well, of the last 3 applicants I send to Celtic with a 10/1/2010 requested effective date, 2 of them were declined. The second came today. A 52 year old non-smoking female with a minor heart issue that the doctor says is asymptomatic and requires no treatment. No other health problems at all.

She was approved by American Republic is 2007 with no riders or exclusions. Now it looks like she'll have to stay with them and the 40% premium increase that hit her 2 months ago.

When I called and spoke to the underwriter, she told me that they (the underwriting team) just came out of a 6 hour meeting and that she is extremely lucky to still be working there. I told her that if she keeps declining applicants who aren't in perfect health, she'll be joining her colleagues in the unemployment line.

Celtic USED to be a company I could count on to issue policies with the least amount of exclusions and rate-ups. Now, they seem hell-bent on finding reasons to decline people. Ever since Centene Corporation bought Celtic in 2009, the company has been on the decline in some key administrative and agent support areas. Now, the employees are being negatively affected by the latest internal changes. What a shame...

I wonder how long these smallish size companies are willing to stay in business? A VP from American Community told us last Winter that if ObamaCare passed, they would prevent losses and get out of the health insurance market before taking any losses. It turns out he wasn't bluffing.

-Allen
 
Your the only person I have ever met selling Celtic. Lol.

"Minor heart issue". Allen your killing me! Lol

The thing about "minor" heart issues is they become major heart issues.
 
Your the only person I have ever met selling Celtic. Lol.

"Minor heart issue". Allen your killing me! Lol

The thing about "minor" heart issues is they become major heart issues.

Well, Celtic has approved minor non-medicated heart ailments in the past. I just started writing with them in 2008 after finding that other agents in the office were getting people approved with Celtic after the major companies turned them down.

TXINSURANCE, What company do you place people with who would are turned down or severely rated by Blue Cross, Aetna, etc..?? For us here in Illinois, Celtic is (oops.. WAS) the one.
-Allen
 
Back
Top