Matching the client with the right plan

[johnrocks]

Well it all goes a lot deeper than just rates. I do a lot of maternity - it's a Maryland mandate that every carrier must offer plans with maternity. Out of 7 carriers in MD only one doesn't offer it. Take a guess.

I'm confused,you said it's a mandate. If that's the case how can that one carrier "not" offer it?

 

[Crabcake Johnny]

If you're association-based you don't have to comply with a single mandate. That's how companies like Mega are allowed to be in literally every state. It's up to the company if they're association-based to decide if they're going to comply.

In MD there's two "biggies" I feel need to be followed - maternity and wellness. In the past the only company who pulled out the "get out of jail free card" was Golden Rule. All other companies complied even though they didn't have to. Assurant has always had maternity and at least one plan with immediate preventative. Golden Rule doesn't offer it and until recently never followed the preventative mandates. So I'll stick with companies that are more client-focused and less focused on profit.

 

[johnrocks]

Thank you John, I honestly did not know that

 

[somarco]

If you're association-based you don't have to comply with a single mandate

That's highly unusual. MD must be the only state where that occurs.

 

[Crabcake Johnny]

Everyone has to realize that my posts are Maryland-based. It's very hard to discuss generalities when everything is so state specific. In MD Golden Rule chooses not to follow the mandates while other carriers do. So until GR decides to be a better citizen I won't be offering them anymore. I don't care if they're offering $100 a month coverage with a free bowl of soup. It's easy to low-ball the rates when your coverage doesn't match up. Can we discuss that GR doesn't cover any reproductive organs/disorders for the 1st six months?

Ya know, when you don't offer maternity, don't follow the mandates, rider pre-ex conditions and yank away drug coverage for anyone meds it's pretty easy to beat everyone in rates.

 

[Crabcake Johnny]

That's highly unusual. MD must be the only state where that occurs.

Must be. Maternity is clearly a mandate in MD and they clearly don't offer it.

 

[somarco]

This is not all inclusive, but I see nothing about mandate maternity benefits here

http://www.statehealthfacts.org/cgi...subcategory=State+Mandated+Insurance+Benefits

 

[johnrocks]

I didn't mean to start a controversy herebut it sounds like(to me at least)that GR is trying to get back to the more traditional ways of what health insurance is;or should be. It is there to cover life's unexpected bumps in the road and more often than not maternity is something to be expected and insurance is like every other type company;they are in business to make a profit

 

[Crabcake Johnny]

This is not all inclusive, but I see nothing about mandate maternity benefits here

http://www.statehealthfacts.org/cgi...subcategory=State+Mandated+Insurance+Benefits

From the DOI website:

 

[J.R.]

Most of my clients end up with a plan lacking copays . . . especially those who listen to my advice. Some, like a lady who bought last month, insisted on buying a copay plan. Proving that she did not listen, she called to complain about the fact her meds were not covered by the plan.

I explained the situation (again) and told her I would be happy to show her a plan that would cover her meds for an extra $380 per month.

I also reminded her that the plan I suggested was $280/month (no copays) vs the plan she picked (with copays) for $500/month.

I don't follow you here. Are you saying that you signed her up for a plan @ $500 a month that did not cover her meds and that she would need to pay another $380 a month for you to put her in a plan that covered her meds and had a copay feature? thanks.

Essentially I recommend a plan I would buy if I were the client. Of course I recognize (and tell them) this is their plan, and their money, and they can buy any plan they like.

How many plans do you normally discuss with clients?

-J.R.