Insurance Employee ACA Knowledge

Nov 19, 2015

  1. SamIam
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    SamIam Guru

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    Don't the customer service reps have to be trained on the products to? I had a customer who takes Humira. I told her once she reaches her out of pocket max it will be 100% right now it's a specialty drug. The rep told her even after out of pocket max she still has to pay co-insurance. They put me on a three way call after arguing the client finally believed me over the CS rep.

    Don't they have to be certified?
     
    SamIam, Nov 19, 2015
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  2. kgmom219
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    kgmom219 What's Next?

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    You're kidding right???????????????????????????
     
    kgmom219, Nov 19, 2015
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  3. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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  4. SamIam
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    SamIam Guru

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    I would assume if your going over client options you have to have some certification or training on product knowledge. Not to the extent we have to but some at least.
     
    SamIam, Nov 19, 2015
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  5. AllenChicago
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    AllenChicago Guru

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    Sam,

    I assume you're talking about Blue Cross. To be honest, this year's BCBSIL prescription benefit has me confused. Take a look at the prescription section on this Silver SOB comparison. It's loaded with unexplained percentages and annotated small print.

    http://www.bcbsil.com/PDF/sbc/2016-compare-marketplace-silver-plans-il.pdf

    There's been a lot of media write-ups this year that describe how Health Insurers are adhering to the broad generalities of ACA Rx requirements, but developing their own convoluted loopholes to shift as much burden to the customer as possible.
     
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