- 4,716
Right on!....When in doubt go with the "Mother ship"
Incarceration = LQE?
- Thread starter somarco
- Start date
Right on!....When in doubt go with the "Mother ship"
I do all on exchange... why? bcbs tx has a glich stating all sep's are post event unless you want to do a paper app... what is this? 1980?
I wrote one last week, direct, last day of employer coverage was 5/31, BCBSTX automatically corrected eff date to 6/1.
BUT...it happens at the end of the online app with a popup.
like I said kg... post event
POST-EVENT of SEP date. Got it.
But I still don't agree. I wrote a woman whose termination date is 7/31 last Thursday, BCBS gave me 8/1 on the popup. No issues.
Maybe they have fixed it recently?
- 1,305
I'm unclear as to what you mean. SEP/QLE rules apply across the board. Could you expand on your statement?
hahaha.... in theory right... in practicality wrong....
In THEORY the rules should apply across the board. In REALITY the exchange is letting everything go through, while the carriers are following the law
- 1,305
Wow...are they telling the consumer that they auto qualify for an SEP?
Miss KG, you are correct... on a side note:
Referral calls yesterday declaring wife had a QLE.... Loss of coverage. There is a slight language gap as he is from Greece and he didn't want my wife to translate... so just me and him... I quiz him hard and some of the stuff he says is: my wife no longer qualifies for coverage... she lives in Texas him in Oklahoma.... informs me that they are not separated and file a joint tax return. He volunteered this info to the point it seemed coached(red flags)
After drilling him hard I determine he has group coverage and due to the wife loosing coverage she is eligible at the spouse group plan... has 4 kids whom he does not want to cover nor are they covered. Again, no subsidy since she can get on group plan at inflated rate.... also seemed coached on how he told me the tax return and number of dependents is structured.
Next, I quote a price without subsidy and he demands low deductible with only 500$ out of pocket. I get a little suspicious about that comment as well(sounded like he was pitching a CSR plan).... I quote $400 a month on the BCBS gold plan with 500 deductible 4K opkt... he blows a head gasket and tells me I am the most expensive agency in the state.... I said how so? now the next part is funny:
He says I called the govt marketplace and they told me I can get a 500 opkt plan for like 100 bucks a month because he is getting a subsidy. He tells me he has already done an application and they see he qualifies... I know damn good and well he dosent.
He demands I write him that plan I tell him no sir, I think in your case getting a subsidy is a violation of federal IRS law as he does not qualify and I in no way shape form of fashion will have my name attached to a fraudulent application..... I tell him to call the marketplace back and take their offer but keep in mind I think you will be paying it all back with the potential raised eyebrow of the feds at tax time...
Lastly, wife has major health conditions... sound familiar? Watch your back boys, they are starting to get educated on how to scam the system....
Referral calls yesterday declaring wife had a QLE.... Loss of coverage. There is a slight language gap as he is from Greece and he didn't want my wife to translate... so just me and him... I quiz him hard and some of the stuff he says is: my wife no longer qualifies for coverage... she lives in Texas him in Oklahoma.... informs me that they are not separated and file a joint tax return. He volunteered this info to the point it seemed coached(red flags)
After drilling him hard I determine he has group coverage and due to the wife loosing coverage she is eligible at the spouse group plan... has 4 kids whom he does not want to cover nor are they covered. Again, no subsidy since she can get on group plan at inflated rate.... also seemed coached on how he told me the tax return and number of dependents is structured.
Next, I quote a price without subsidy and he demands low deductible with only 500$ out of pocket. I get a little suspicious about that comment as well(sounded like he was pitching a CSR plan).... I quote $400 a month on the BCBS gold plan with 500 deductible 4K opkt... he blows a head gasket and tells me I am the most expensive agency in the state.... I said how so? now the next part is funny:
He says I called the govt marketplace and they told me I can get a 500 opkt plan for like 100 bucks a month because he is getting a subsidy. He tells me he has already done an application and they see he qualifies... I know damn good and well he dosent.
He demands I write him that plan I tell him no sir, I think in your case getting a subsidy is a violation of federal IRS law as he does not qualify and I in no way shape form of fashion will have my name attached to a fraudulent application..... I tell him to call the marketplace back and take their offer but keep in mind I think you will be paying it all back with the potential raised eyebrow of the feds at tax time...
Lastly, wife has major health conditions... sound familiar? Watch your back boys, they are starting to get educated on how to scam the system....
