Impact of PPACA So Far

[somarco]

I went to healthcare.gov to find out. Answer - don't try to get any answers from healthcare.gov. Their website is pretty, but stupid,

One of the services I subscribe to printed a notice from HHS to carriers letting them know their loss ratio reports are due. Even the data that is on the site is confusing at best and meaningless to most who would go there for information.

When you have consumers that buy plans without Rx and either think they have Rx coverage or simply don't care "because I don't take any meds", these rocket surgeons aren't going to take the time to wade through documents on loss ratio's, etc to make a decision on which company they want.

These are the same folks that show up at public meetings talking about how the insurance company denied their claim because they got sick after the policy was issued.

 

[Yagents]

Unless I'm missing something.....ST is not subject to PPACA. That's why it still pays higher commish schedule, not GI as they have to answer no to the 5 q's, has no prev care, lifetime limits of $1-2m, and does not cover pre-ex....even for children.

 

[somarco]

Yes, STM is not subject to Obamacrap and it is only slightly better than a mini med.

 

[Yagents]

I think more than "slightly better". It's real major medical, vs. limited. ST is the pure definition of insurance, removing risk from your future, and actually have it pay off if needed. Lim benefit, never sold one, is about assisting with past/current risks, with very little help for future unknowns.

2 different platforms, I'll choose the MM platform everytime if insurable. Don't care to get the following call...ever: "my wife died, or i'm now bankrupt, or a lawsuit is coming, because of the policy limitations".

 

[Ann H]

One of the services I subscribe to printed a notice from HHS to carriers letting them know their loss ratio reports are due. Even the data that is on the site is confusing at best and meaningless to most who would go there for information.

When you have consumers that buy plans without Rx and either think they have Rx coverage or simply don't care "because I don't take any meds", these rocket surgeons aren't going to take the time to wade through documents on loss ratio's, etc to make a decision on which company they want.

These are the same folks that show up at public meetings talking about how the insurance company denied their claim because they got sick after the policy was issued.

There's another thread on this forum called, "NAIC to hold public hearing in Austin on commissions", in which this link is posted - AHIP to NAIC: Well-Paid Producers Important to Exchange System - Regulatory,Legislative and Tax Issues - Life and Health Insurance News. In that article it says, "But the NAIC consumer reps argued that the new Navigators need not be health insurance agents because they will simply give consumers information about the health plans sold through the exchanges. Because of PPACA changes, consumers will not need help with complicated underwriting problems and likely will face fewer problems with claim denials and benefit exclusions, the consumer reps say. "However, they will need help understanding plan quality ratings, the meaning of satisfaction surveys, and the value offered by different plan tiers," the consumer reps say.

When I read that paragraph, I thought, "yeah, sure." Navigators can be from the Dept. of Game & Fish, other govt departments, or non-profit organizations. I'll bet none of them have counseled a family about their financial situation, done a needs analysis, nor assessed the probability or risks in the future, much less set up a plan to provide for today and tomorrow's medical & financial needs. But, apparently they can weed through the loss ratios, quality ratings and satisfaction surveys to find meaning there???!!!

 

[somarco]

Consumer - Which of these plans is best for me?

Navigator - This is the cheapest. No reason to pay extra when you don't need to.

(This is the same kind of advice consumers get when they call direct to a carrier).