Humana Claims

[bill3173]

I have recently started to present Humana products(individual) more aggressively to my clients, mainly because the account rep for this area has consistently called for feedback and thanked me for every single app that I've placed and I've had no problems, thus far, my current clients have been happy with them. Their plans are well designed, and competitively priced, so they are a good offering from that stand point. However, I don't have a long enough history with them to know how well they treat their clients regarding claims(20 clients over 8-9 months, is not convincig evidence for me).

1. Are they quirky about certain items.
2. Do they engage in that "post issue" underwriting if someone sees a doctor for a sprained arm in the first 6 months.

Any humana experts out there? Mr. Somarco?

 

[somarco]

I have been dealing with H1 for over a year and no issues. Have only had one complaint and that was someone who did not read their policy regarding the 90 day wait on wellness.

They don't do post claim underwriting. All of the underwriting is done at point of application. They use the app, phone interview, MIB and Intelliscripts to flesh out any issues on the front end.

I am currently using Aetna, H1 and GR primarily in that order. My Aetna business has increased significantly in the last 2 months since they introduced some new plans and pricing (particularly on the HDHP).

I am cautiously optimistic about a long range relationship with Aetna.

H1 would still be my primary carrier if Aetna had not adjusted pricing.

H1 and GR are the easiest to work with, but GR's pricing in particular puts them out of the market for most of my clients.

I can't say enough good about H1.

Keep in mind the 90 day wait on preventive and the 12 month wait (at least in GA) on psych. Other than that, a clean contract and good people to work with.

 

[bill3173]

I have been dealing with H1 for over a year and no issues. Have only had one complaint and that was someone who did not read their policy regarding the 90 day wait on wellness.

They don't do post claim underwriting. All of the underwriting is done at point of application. They use the app, phone interview, MIB and Intelliscripts to flesh out any issues on the front end.

I am currently using Aetna, H1 and GR primarily in that order. My Aetna business has increased significantly in the last 2 months since they introduced some new plans and pricing (particularly on the HDHP).

I am cautiously optimistic about a long range relationship with Aetna.

H1 would still be my primary carrier if Aetna had not adjusted pricing.

H1 and GR are the easiest to work with, but GR's pricing in particular puts them out of the market for most of my clients.

I can't say enough good about H1.

Keep in mind the 90 day wait on preventive and the 12 month wait (at least in GA) on psych. Other than that, a clean contract and good people to work with.

Good to hear your comments on Humana. That has been my impression to date. I have used Aetna, AMS, Assurant, H1 in that order, and am also concerned about the long term relationship with Aetna. Particularly their latest sneak attack on the v10000 policy commissions. Oh by the way, we are reducing your commissions from 20/5 to 7/3, effective this month.

Why are you concerned about Aetna?

 

[joshril]

I agree that H1 is great to work with. I have had a higher percentage of APS's pulled with H1, but as Bob mentioned, no post-claim underwriting.

I would say currently Aetna is also my top carrier, but H1 has been getting more of my business where they are competitive.

 

[somarco]

My concern about Aetna is the ability, or inability to deal effectively with the individual market place. They were a strong player 30 years ago or so then whimpered out. They made a few feeble attempts to re-enter before finally making a concerted effort starting 3 - 5 years ago.

They have this big carrier mentality (more so than most of the others) and seem to think their crap doesn't stink.

Some of my concerns have been voiced already, by myself and others, but here is the short list.

Contract issues such as no psych benefits (here in GA).

Online app is the worst, bar none.

Rating is killer on families when 1 or more family members have a ratable condition. They kill the idea of a family policy by splitting the rated member(s) off the rest of the plan. This is especially disconcerting on an HDHP.

Some of their underwriting is overly harsh while other things are liberal. It seems like they are trying to find themselves in the market.

Commissions. Something you (and others have addressed). I haven't had that problem . . . yet . . . but anticipate it will crop up as I write more business. Right now my biggest commission issue is waiting 60 - 90 days until a new case cranks through their system and ends up in my bank account.

AOR. No doubt, the most arrogant and ignorant thing they have done is to grant AOR but continue to pay the writing agent and denying the new agent of the right to comp. What *** thought that was a good idea?

Taking 60 days to issue a policy and claiming that is the industry standard. Someone needs to pull their head out of their butt on that one.

And that is my short list . . . .

They have decent name recognition although I seem to be the only one who remembers "Aetna, I'm glad I met ya".

Quite a few folks pronounce it Atena.

Of course that could be a southern thing . . .

They will probably become a major player but that is anyone's guess.

FWIW I understand H1 is running out new "annual max" plans in some states including neighboring Alabama. Seems they couldn't sell their "high priced" major med plans . . . or dental . . . so they are coming out with Right Start type plans.

That's pretty stupid if you ask me but they didn't.

Based on what I see in my world, Blue will continue to be a factor but their position in the IMM market is weakened. UHC1, H1 and Aetna will continue to fight for market share.

If Time could get their act together they could be a player somewhere other than MD.

The others are just also rans.

 

[moonlightandmargaritas]

CoventryOne (that's unique, isn't it?) has begun their long-threatened roll-out here in Florida...

Just what we need, one more "me too" carrier!

 

[bill3173]

FWIW I understand H1 is running out new "annual max" plans in some states including neighboring Alabama. Seems they couldn't sell their "high priced" major med plans . . . or dental . . . so they are coming out with Right Start type plans.

I went to a H1 meeting here yesterday, and they are rolling out the limited plans in 2009 NC, SC and Ga, unsure about other states. I handle the RS plans this way, if the client will take on a cancer plan or CI along with it, then I'll sell it and worry about it. Better for them to have it than nothing. When possible, I replace the RS plans that I currently have on the book. The last one was replaced with BX, now that can make your day.

 

[EasyInsuranceSales]

If Time could get their act together they could be a player somewhere other than MD.

LOL - We were talking about this same thing today. I love the 3 year price guarantee with Time and the com. isn't bad but it can be hard to sell out west.

 

[joshril]

LOL - We were talking about this same thing today. I love the 3 year price guarantee with Time and the com. isn't bad but it can be hard to sell out west.

I hate the 3-year price guarantee... except for a 62 or 63 year old. After 3 years the rate increase is super nasty...

 

[TXINSURANCE]

AOR. No doubt, the most arrogant and ignorant thing they have done is to grant AOR but continue to pay the writing agent and denying the new agent of the right to comp. What *** thought that was a good idea?

That would be me.

I am lobbying all carriers to implement this policy.

Too many agents make a living off of AOR instead of actually spending money on marketing and getting new clients.

You want to steal clients all day? I'll give you my friends number who sells Auto insurance. It is slimy.