Health Net cracks down on agents

[Guest]

Health Net is cracking down on agents who do "what is best" for their clients.

Health Net HSA-Compatible Plans & Self-Funded Deductibles

Other carriers have this same policy but I've never seen it spelled out as harshly as in this letter, which I'm sure was written by some PR genius at HN and not Benefit Mall.

Why doesn't HN (et. al) just stipulate that they won't pay claims on self-insured HSA or HDHPs instead of beating the agent over the head? If the boss wants to self-insure the deduct he can... but YOU don't get paid. How terrific is that?


Al

 

[GreenSky]

Old news.

Rick

 

[senior-advisor-indiana]

Do you see what happens when agents work part time Rick?

 

[djs]

Didn't Kaiser send out an almost identical letter recently?

 

[Mr. Bill]

Honestly I don't understand what their problem is. Why should they care? Al, isn't this a case for Steve Poizner to straighten out?

 

[Guest]

Honestly I don't understand what their problem is. Why should they care? Al, isn't this a case for Steve Poizner to straighten out?

It is an interesting issue. Somewhere in the CA state ins. regs there is something about how agents have to do "the best" for their clients. So if a boss says "I want an HDHP plan for my folks and I'll self-insure the deduct" am I to say "No, don't do that because if you do I won't get paid." That's the position HN and the others have put agents in.

Will the DOI get involved? I think he should, but right now I think he has bigger fish to fry than worrying about agent commissions on self-insured plans.

What is interesting is that the carriers don't have an issue with voluntary "medical bridge" supps like Aflac or Colonial sell that will indemnify the deductible, so long as the prems are paid by the employee. (I heard that none of the carriers wanted to mess with the deep pockets of the Aflac lawyers.)

I took the issue to NAHU and the president of CAHU, Neil Crosby wrote and said he would call me on Thursday to discuss it. NAHU/CAHU won't do anything... they are bought and paid for by the big carriers and the GAs, at least in my opinion. I'm a member but probably won't renew in December. $450 a year dues for what? Nothing that I can see.

I understand the carrier's position. Utilization goes up when the deduct is insured and that wrecks havoc with how the plan is to perform (from a P&L standpoint.) However why make the agents the scapegoat? Why don't the carriers just say "We will not pay any claims on any policy if we learn that the HDHP deducts were insured or indemnified." We're the people who bring them the business and they want to penalize us if the boss wants to do a good thing for his/her people. It makes no sense.

I'm glad I sell more life insurance than health these days. It's nice to "love" the company you represent. Do any of you "love and respect" your health carriers? I don't love mine. Half the time I'm fighting with them over a UW issue or a claim. Single payor can't come soon enough for me! I'll be happy to sell GI supps for Obama-care. Even at 5% commission it will be shooting fish in a barrel.

Al
Mutual of Omaha

 

[Mr. Bill]

There won't be any Obamacare. It will be interesting to watch what he does next after losing. That said, we need serious health care reform, along with tax reform, government reform, lobbyist reform, and a whole host of reforms.

 

[Dave020]

Not sure what the big deal is here, employer cannot reimburse expenses under an HSA deductible (no HRA), however employer can FUND the HSA account for the employee.

 

[Guest]

Not sure what the big deal is here, employer cannot reimburse expenses under an HSA deductible (no HRA), however employer can FUND the HSA account for the employee.

To quote from the link above (first post in thread):

Under no circumstances may any of the HSA compatible or other high-deductible products be combined with any form of partial self-funding or insuring of the deductible, be it in a wraparound, addition or companion capacity.

I can understand the carriers side. But when I see language like this:

This Guideline was made effective May 1, 2006. Health Net will not pay medical plan commissions for any policyholder found to be out of compliance with the Partially Self-Funded Deductible Plans and/or Section 105 Plans Underwriting Guideline.

Deviation from this requirement also may result in termination of your Health Net Agent/Broker Agreement. In addition, you should check your E&O policy, which may exclude liability for claims arising from self-funded arrangements.

... I see a carrier out of control.

I ask why WE are to be made the scapegoat for something we don't have total control over. We can't stop a company from self-insuring a deduct. And we shouldn't try to. Why not punish the client instead of the sales agent?

Al

 

[Dave020]

Well, if you want to know who is to blame for this, in one word..."Benelect". They started this and it has snowballed.

Again, carriers want at least the appearance that the employee is not receiving 100% first dollar coverage (which escalates utilization through the roof). However, since the employer can fund the employee's HSA and be completely legit on this with all of the carriers, there really isn't that big an issue. The difference it that the HSA is the employee's asset, and would not fall under the category of self-insurance/funding.

If the employer wants to reimburse, then let them fund the HSA instead.

I ask why WE are to be made the scapegoat for something we don't have total control over. We can't stop a company from self-insuring a deduct. And we shouldn't try to. Why not punish the client instead of the sales agent?

Company must sign a disclosure that they will not do this. Carrier has the right to rescind coverage if employer violates that agreement.