LaffAgent
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- #32
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You don't help others and enrich yourself? Who is talking 'kaka' now?
She is only trying to help them get insurance. Don't we all do that? And once we get them one product, don't some of us try to sell a second?
I fail to see any difference between what she is doing and what you are doing in offering Assurant contracts, or what Mary is trying to do in building her agency... etc. Putting someone in their downline is no different than putting an agent under contract to you. Zero.
If you want to take her to task for walking a thin legal line with respect to insurance law, fine.
But she is not doing anything differently than most financial planners would do, most business consultants would do, etc. She is giving advice and her clients are free to take it or leave it. It's no different than with your clients.
It's not like she is dealing with poverty-row. Her clients are working people who are not stupid, they simply got blind-sided by the health insurance system and are now shut out of it because they are too sick to get accepted, are too rich to qualify for Medicaid and too poor to afford MRMIP or COBRA. Are you going to tell me that you have not met any of 'these' people? She has 'found' a way to help them. Legal? Ethical? I have not decided yet. But unlike some of you, I stand up and applaud her.
I don't know if it is true, but I could make a case that she is putting her license on the line to do what she can to help others. Again, is it 'right'? You make the call.
My 2 cents. YMMV.
Al
I don't think anybody has said it's illegal with what she's doing. There has been some question about whether it is ethical.
Remember, just because something is legal doesn't make it ethical.
It all depends what the intent is, something that initially came across as she is setting them up in business in order to get them health insurance. This is not ethical.
If she is setting them up in business, and offering health insurance, and they are accepting it, then it could be ethical, if it passes a few other legitimate gut level tests.
How can you tell the difference from the outside? If a large portion of her group health are her downline and a large portion of those would not qualify for individual health, then chances are, what she is doing is unethical. Funny thing about ethics though, is it is in the eyes of the beholder, not in the eyes of the person doing it.
Basically, anytime you are doing things to work around rules, chances are, it's unethical. That's not to say writing group health with uninsurable people is unethical, as long as it is a legitimate business. Only your gut will tell you if it's right, but since the question originally was setting up a business to get GI group health, not the other way around, your gut should get twisted in a knot with flags going off everywhere.
Who does it hurt? Guaranteed not the insurance companies. They raise rates on the other small groups to cover it. So if you can sleep at night knowing you took money away from a small business owner to get your person coverage, then your probably okay. Nobody is going to convince you this is the wrong thing to do.
It's not just who you help, it's who you hurt at the same time. Does 1 or 2 small groups make a difference? No. Almost every agent in California knows they could do this (at least if they ever thought about writing group health), but very few play the system this way. Why? Think about it.
It's not a new, out of the box way of thinking.
Dan
Remember, just because something is legal doesn't make it ethical.
It all depends what the intent is, something that initially came across as she is setting them up in business in order to get them health insurance. This is not ethical.
If she is setting them up in business, and offering health insurance, and they are accepting it, then it could be ethical, if it passes a few other legitimate gut level tests.
How can you tell the difference from the outside? If a large portion of her group health are her downline and a large portion of those would not qualify for individual health, then chances are, what she is doing is unethical. Funny thing about ethics though, is it is in the eyes of the beholder, not in the eyes of the person doing it.
Basically, anytime you are doing things to work around rules, chances are, it's unethical. That's not to say writing group health with uninsurable people is unethical, as long as it is a legitimate business. Only your gut will tell you if it's right, but since the question originally was setting up a business to get GI group health, not the other way around, your gut should get twisted in a knot with flags going off everywhere.
Who does it hurt? Guaranteed not the insurance companies. They raise rates on the other small groups to cover it. So if you can sleep at night knowing you took money away from a small business owner to get your person coverage, then your probably okay. Nobody is going to convince you this is the wrong thing to do.
It's not just who you help, it's who you hurt at the same time. Does 1 or 2 small groups make a difference? No. Almost every agent in California knows they could do this (at least if they ever thought about writing group health), but very few play the system this way. Why? Think about it.
It's not a new, out of the box way of thinking.
Dan
- Thread starter
- #34
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Guest
Guest
Let's not hire older workers because they will raise the rates of the group.
Let's fire that person who got sick because they are raising the rates of the group.
Let's not hire young women as maternity will raise the rates of the group.
Let's not hire that young father because his daughter has cancer and it will raise the rates of the group.
Lets not give a damn about anyone but ourselves.
Well I take a different view.
If everyone has to pay higher rates but it allows everyone to get insurance, well to me that's fine. If the carriers had their way they would NEVER insure anyone who is old or who had ever had any kind of illness.
Why is the insurance industry so highly regulated? Is it because of the high ethical standards of the carriers? Maybe not so much!
Let me get up close and personal. If a couple came to you and said "Is it true that if we start a business we can get insurance?" what would you answer? Of course you would say 'yes.' You would not lie.
When they ask "Will you give us some advice and some assistance in starting a business?" Would you turn them away? I'm sure most here would. I think most would refer them to a business consultant, maybe the SBA SCORE, or maybe just a good 'start your own biz' book.
After they started their Mary Kay, or pet-sitting, or handiman business and came back to you 3 months later, knowing what you know, would you write them?
I would. And I'd sleep fine at night.But that's because I don't see my prime role in this industry as a shill or as a mouthpiece for the carriers. Yes, legally I am. But it is not how I comport myself. I'm here to do a good service for my fellow citizen.... my customer... my friend. (There are limits, of course. I don't want to take up residence in Lompoc!)
Al
- 14,809
Well Al, you've had your answer in several posts you just don't agree with it. And the difference is I don't encourage my agents to participate in fraud. If you don't think it's fraud they contact the insurance company when you fill out the group app and disclose what you're doing - see if it gets issued and if you keep your appointments. Or just call the insurance companies you write with today and simply ask.
I'm sure you learned in your insurance training that you have a duel role - to protect the client and insurance company. I'm also sure if you contacted the CA DOI and ran this past them you know what your answer would be.
If I have personal knowledge of a health condition a client didn't disclose does it go on the app? You betcha. Because part of my job is to protect the insurance company. Why should they be protected? Because when they get burned honest people's rates go up.
Should you go to jail if you shoplifted a coat to give to a freezing homeless man? No. It is a crime? Yes.
- 2,908
Why is the insurance industry so highly regulated? Is it because of the high ethical standards of the carriers? Maybe not so much!
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Because so many people will do whatever is not illegal and confuse it for being ethical.
Winter
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Because so many people will do whatever is not illegal and confuse it for being ethical.
Winter
LaffAgent
Expert
- 68
Al-
Your enthusiasm to help consumers be protected from the inequities of big insurance business is noble. However, that objective is the primary focus of some other occupation, not of an insurance agent. Perhaps you could start an insurance advocacy group, that would be a better way for you to pursue those goals than being an insurance agent.
If your calling is to help consumers maneuver their way AROUND the rules and guidelines of the insurance industry in order to help them, you shouldn't be doing it under the banner of an insurance agent.
Your enthusiasm to help consumers be protected from the inequities of big insurance business is noble. However, that objective is the primary focus of some other occupation, not of an insurance agent. Perhaps you could start an insurance advocacy group, that would be a better way for you to pursue those goals than being an insurance agent.
If your calling is to help consumers maneuver their way AROUND the rules and guidelines of the insurance industry in order to help them, you shouldn't be doing it under the banner of an insurance agent.
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- 14,809
I think that's a great post. Al, you might do better as a consultant and advise your clients on their choices. As an agent you have a duty to protect the insurance company. If you do not want to protect the companies you work for it would be best to reconsider being a licensed agent. And if your distain for insurance companies is as great as I think it is I don't see any success for you in this line of work.
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- #39
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I didn't think this thread would morph into a personal attack on me as an agent but like so many others (to others) in this forum, it has.
I'm gone from this thread. Let it die... and let your attacks disguised as 'friendly advice' die with it.
I'll retire from the forum... at least for a while... as well. I'm obviously riding a different color horse and in a different direction than some of you... and some of you have a problem with it. That's fair. You are entitled to your opinion.
Thanks for the use of the hall.
Bye.
Al
- 14,809
Well Al in all honesty you're a very new agent seeking advice. The advice you've received from very experienced agents overwhelmingly is what this girl is doing is unethical, an insurance voilation and if she was honest with her carriers she'd lose her appointment - yet you just come back over and over defending the idea.
I agree with you that many parts of this system are broke. If your answer to the fact that it's broke is to defraud the insurance companies you represent you should look into other lines of work.
I agree with you that many parts of this system are broke. If your answer to the fact that it's broke is to defraud the insurance companies you represent you should look into other lines of work.
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