How Many?

[moonlightandmargaritas]

That's exactly my point Paul.

Say I wanted to market a plan and get it approved by the DOI... To make people happy the name of the plan will be called "Bull%%!" Now, I have to get Bull%%! approved by the DOI, but how do they determine what type of plan is it? Does a plan become a mini med if it caps prescriptions @ 100K, outpatient at $30,000. Where are the guidelines???

Can only speak for Florida.

A "major medical plan" (such as I described) would be filed and approved as a major medical plan by the Florida DOI.

Anything with limits (a Mega plan would be an example) they would only approve as being called a "Hospital & Surgical" plan.

Other states of course will differ. Hope that helps!

 

[indmedins]

Can only speak for Florida.

A "major medical plan" (such as I described) would be filed and approved as a major medical plan by the Florida DOI.

Anything with limits (a Mega plan would be an example) they would only approve as being called a "Hospital & Surgical" plan.

Other states of course will differ. Hope that helps!

Where do I look for a list of those Paul? Here...
Florida CFO Alex Sink/Department of Financial Services

I know which are which, just might like to offer this info to a consumer from time to time when necessary.

BTW, did I start this thread? Wow. Never thought this one would've lasted.

 

[ABC]

Just curious.

What do you tell the client who bought one of those plans when they were healthy, then later NEEDED one of those pricey, brand name drugs . . .?

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The problem is, you are thinking like a consumer. They look for coverage for their current (or past) medical situation. They never think in terms of what might happen in the future.

That is very shortsighted and foolhardy.

First I totally disagree with you.
The person that is going to buy this plan:
They currently dont have health insruance. They also want some type of OV copays. What also adds to this plan is the fact generic drugs are aviable for $4.

I dont know what your experience is in the unisured market since you turn away so many people but what I am seeing is it all about price.

For $14 more a month this prospect could have gotten an HSA plan with a $3,000 deductible. She did not want that plan. I did a side by side comparison with the two plans and she chose the economy plan.

Am I not going to submit the app because its not the best plan for her? The way I look at it is its still going to cover for the $100,000 claim.

I think everyone should be on a HSA plan and I pitch it to everyone I talk to. Not everyone want to take controll of their health care.

 

[somarco]

You may disagree if you like, but you failed to answer my question.

What do you tell the client who bought one of those plans when they were healthy, then later NEEDED one of those pricey, brand name drugs . . .?

And yes, I don't spend a lot of time with those who are uninsured now, particularly if they have been uninsured for more than a few months. I can't afford to work with them especially since they will most likely drop the plan in a few months.

I also don't want to have the conversation with them, or their attorney, when their health changes and something isn't covered. It just makes my life simple.

 

[ABC]

You may disagree if you like, but you failed to answer my question.

What do you tell the client who bought one of those plans when they were healthy, then later NEEDED one of those pricey, brand name drugs . . .?

And yes, I don't spend a lot of time with those who are uninsured now, particularly if they have been uninsured for more than a few months. I can't afford to work with them especially since they will most likely drop the plan in a few months.

I also don't want to have the conversation with them, or their attorney, when their health changes and something isn't covered. It just makes my life simple.

I am sorry i did not answer your question.
Its not covered! $500 is not enough coverage for Brand name drugs.
I can't tell you how much I stress this when I sell a plan like this.

You have answered my question clearly. Your really not working with the uninsured market and I don't blame you.
The uninsured market is super tough. Your dealing with low budgets for health insurance.
My attitude towards the health insurance business is I don't walk away from anything. It might be a $54 a month indiviudal sale or a $1 million group. I will take it all.

Marco
I don't know how you are getting such qualified indiviudal sales but good for you. You have some type of niche and I would say you are working very smart. To beable to turn away biz. is amazing. Your one of a kind.

 

[Guest]

Yes it seems many people on the forum either have the ability to, or have decided to turn away business they feel is a hassle or inconvenient to them.

Imagine if they just considered the client at all times, above all else.

 

[bill3173]

Yes it seems many people on the forum either have the ability to, or have decided to turn away business they feel is a hassle or inconvenient to them.

Imagine if they just considered the client at all times, above all else.

With all due respect and etc. etc. I don't think that that's what Mr. Somarco meant at all. I don't work on every case that is presented to me, and its not driven purely by self interest. Using some good guidelines for case writing, can keep people from throwing away their money on policies that they won't keep, or could not get issued at a reasonable rate, and allows you to assist others to the best of your ability.

I recently had a lady in her late 50's who wanted a major med policy with a recognized carrier, with diabetes (oral med) and hbp, her ht wt were good, she claimed to be in good health otherwise. It would be difficult, but not impossible to get coverage. Next she told me $150 month was the most she could pay, and wanted to include her teenage son. There was nothing further for me to do at that point.