Help with field underwriting

Jul 19, 2007

  1. slushhhpuppie
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    slushhhpuppie Super Genius

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    I am trying to find the right product/carrier for a client (she's already been declined from Highmark BlueCross) and I don't want to just throw it at every carrier... any suggestions?

    54 year old female in Pennsylvania
    5'5" 220 lbs
    b/p normal
    cholesterol is 228 - treated with crestor, 5mg/day (for 4 months)
    hypothyroid - treated with synthroid, 125mg/day (for 20 years)
    anxiety - treated with zoloft, 100 mg/day (for 10 years)
     
  2. Dave020
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    Dave020 Super Moderator Moderator

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    I'd suggest contacting the underwriting departments at the carriers you are considering and find out directly from them what they think about this case.

    Couple of things to think about here:

    Go to drugstore.com and price 30-day supplies of the three medications. Now use that as no more than 20-25 percent of total premium and you get an idea of the minimum premium she would need to pay to even be considered for coverage.

    The BMI is way high (37) which coupled with cholesterol will create some problems in underwriting as well.

    Zoloft is an underwriting killer as well, especially at her dosage.

    Now PA may differ from CA, but if this case came to me out here, I know it's an across the board decline right from the start. Too many things going on here.
     
    Dave020, Jul 19, 2007
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  3. salpro22
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    salpro22 Guru

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    Were you able to find out what her premium range is monthly? Aetna is going to crucify her, GR will be priced competitively with riders on any of their quality plans, while Assurant is going to increase her at least 50% due to her H/W and HC, not counting the anxiety medication which is a 25% rate up with no counseling depending on the plan. Is she looking towards a standard plan or HSA?

    This might be a GI plan w/ BCBS. Which county is she in?
     
    salpro22, Jul 19, 2007
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  4. somarco
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    somarco That Medicare Expert Guy

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    GR will decline.

    Three riders and you are out.

    I don't see anyone taking her.

    Time will probably reject her as well. When the loads get to 80% they decline.
     
    somarco, Jul 19, 2007
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  5. Crabcake Johnny
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    Crabcake Johnny Guru

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    Called my underwriter - 65% rating on the CoreMed plan. I am NOT saying that's what I would recommend - just saying she'd get an approval for that plan solely based on what you posted.
     
  6. slushhhpuppie
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    slushhhpuppie Super Genius

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    Wow, you guys are great.

    Thanks for the help, health insurance is a value-added service I offer to new advisory clients (and frankly, I've only had a few ask for it), so I'm not very well-versed in underwriting guidelines.

    And for SalPro, she is in Allegheny County (Pittsburgh).

    Thanks again all!

    PS-- Zoloft is on an as needed basis, client indicated to me that she only refills 1-2x yearly
     
    Last edited: Jul 19, 2007
  7. GreenSky
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    GreenSky Guru

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    There was a time when I had a Series 7/63. Since I did not do it as a primary focus, I was not very sure of myself. I finally decided if I could not be an "expert", I was not doing my clients any good with securities advice. I no longer hold the licenses.

    If you do not focus on health insurance, you might want to just farm it out to an agent who does. In return, I would expect an occasional referral. Being not "very well-versed in underwriting guidelines" makes it difficult to consider your services as "value-added."

    But, you did come to the right place to get questions answers. I learn something new here constantly.

    Just my 2 cents.

    Rick
     
    GreenSky, Jul 19, 2007
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  8. slushhhpuppie
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    slushhhpuppie Super Genius

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    I used to have an arrangement like this; I would refer my investment clients for health cases..... until the scumbag tried pitch an annuity to one of my referrals.

    Luckily it was one of my oldest (and most loyal) clients, so she laughed at him, but still, I learned my lesson.

    My average annual revenue per (advisory) client is $12,000 per year - I can't risk some agent getting cute.
     
  9. salpro22
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    salpro22 Guru

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    I have heard that I'm a good looking guy, although I don't like to boost, so I can guarantee that I won't be cute. Having said that, I can't help genetics. Do you have a website?
     
    salpro22, Jul 20, 2007
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  10. GreenSky
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    GreenSky Guru

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    On the other hand, you can 't risk screwing up because you don't have the expertise.

    You do have a valid argument. Hope you can find someone you can trust.

    Rick
     
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