Mega Strikes Again NASE/UGA/HEALTHMARKETS

Discussion in 'Health Insurance and Ancillary Benefits' started by moonlightandmargaritas, Sep 14, 2006.

  1. moonlightandmargaritas
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    moonlightandmargaritas Guru

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    Just got off the phone with a guy who's wife just had a 4 way bypass...and coverage with Mega. He's just now realizing what sort of exposure he had/has. Poor b*stard. How do they get away with this limited stuff without some disclosure? Or is it ultimately the consumer's fault for not doing enough due diligence? I talk to some people with their coverage, and they think it's the greatest thing since sliced bread.
     
  2. somarco
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    somarco Guru

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    As long as there are gullible people, carriers will continue to write this kind of crap and the discount plans will proliferate.
     
  3. midwestbroker
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    midwestbroker Guru

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    Most people do not know what questions to ask. Most of the agnets don't know any better either.

    Here is your deductible, here is your office co-pay, here is your premium. Sign here.

    People spend more time shopping for cars then their health insurance.
     
  4. James
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    James Guru

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    I always thought that it seemed strange that the big H/C's such as United Health, Assurant, Humana etc etc don't do a big public education push about Health Insurance. Esp. since they are getting so much bad press of late.
     
  5. somarco
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    somarco Guru

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    At least 2 of those 3 carriers have their own version of a watered down policy at a cheap price. Someone in HO must have decided if you can't beat them, join them with junk plans.

    In fact, I attended a training session hosted by a local IMO to roll out the new product line. We were told "now you have something to compete with Mega".

    Stupid idea if you ask me.
     
  6. Crabcake Johnny
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    Crabcake Johnny Guru

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    It's the agent's ultimate responsibility to offer or not offer any of these limited plans. Clients do not understand the concept of future liability, but you can better believe you'll be the one hung out to dry if the client gets nailed with a huge bill they can't pay. The insurance company will wash their hands by saying two things:

    1) Sir, you had 10 days to review the policy

    2) Your agent was responsible for not only recommending a plan to do but fully going over all the limitations.

    This is why under no circumstances do I sell limited plans without getting something signed by my client stating that:

    A: They were presented with many options
    B: They understand the limitations of the plan

    If they won't sign that I won't sell it. Period. It's amazing how many people will squeeze out that extra $30 a month when I say "Ok, but I'd like you to sign something that releases me from liability if you actually need to use the plan."

    Use can use this formula:

    Major bill the client can't pay = someone's getting sued

    And the first thing both the insurance company and the attorney will want from you in writing? A statement from you stating that you, in detail, went over every aspect of the plan.
     
  7. STIBROKER
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    STIBROKER Super Moderator Moderator

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    John....do you need help resizing that avatar......
     
  8. STIBROKER
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    STIBROKER Super Moderator Moderator

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    hummmmm.....look at what just hit the board......

    http://www.stuartlaw.us/practice-areas.jsp#hinsurance_fraud

    Clyde and Debbie Hart, Diablo, California

    The medical group where the Harts preferred to receive their care decided not to maintain a contract with Blue Shield. So the Harts looked for new coverage that would permit them to continue with their existing doctors. An agent for a division of the Mid-West National Life Insurance Company of Tennessee delivered a three-hour sales presentation to them at work. During the presentation, the Harts went through their existing Blue Shield coverage line by line, and the agent assured them the Mid-West policy provided all the same coverage. The Harts decided to purchase the policy only after a second sales presentation. Then, when Clyde underwent a six-vessel cardiac bypass surgery, they learned the policy was not comprehensive. The Harts are now left with nearly $175,000 in costs the insurer will not cover. They are represented by Stuart Law Firm in an action for fraud against Mid-West, UICI, and the Alliance for Affordable Services

    Darlene and Dave Henderson, Penn Valley, California

    In April 2000, Darlene and Dave Henderson met with a salesman for the National Association for the Self-Employed who showed them the MEGA plan, which appeared to them to be a group PPO similar to others they had seen. David Henderson required surgery for a life-threatening aneurysm and a subsequent colostomy at a total cost of over $190,000. They learned the policy was not a group policy, and that its maximum benefits were very low in relation to typical medical expenses. MEGA paid just 14% of Dave’s medical expenses. Dave complained to the salesman, who said not to tell anyone. “I could lose my license,” the salesman said. The Hendersons’ case against MEGA and the National Association for the Self-Employed is scheduled for trial in Nevada Superior Court in May 2006. They are represented by Stuart Law Firm.

    Linda and Jerry Hopkins, Hawthorne, California

    After Jerry and Linda Hopkins purchased their MEGA policy in October 2004, Linda was diagnosed with stage-three ovarian cancer. She underwent surgery at a local medical center, where her bills totaled $250,000. Of this amount, MEGA agreed to cover $20,000. At the medical center, Jerry Hopkins was told there were four others in the cancer ward with the same insurance—and the same problem. Later, when Linda’s cancer returned, the medical center told Jerry it would be unable to provide the treatment she needed because her coverage was so poor. The Hopkins have retained Stuart Law Firm and are asserting a claim for fraud and violation of California ’s Consumer Legal Remedies Act.
     
  9. STIBROKER
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    STIBROKER Super Moderator Moderator

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    bought a lead today off a site that will let you buy by the lead one at a time....well needless to say I knew they were being bombarded but both were smokers so I knew aetna was the lowest smoking rate so forked $6 to see if any agents were throwing aetna down.....came up with unicare,assurant,NASE,and some one who said that aetna was there best rate and waiting for the email....so after about 45 min's on the phone he says your the agent we have been looking for and for grins ran the nase agents record for him and sent him to google for nase sucks,......so I come up with a tag team husb. and wife team with these stats...

    wife
    General Lines Agent Life, Accident, Health and HMO 03/2006 03/2008 Active
    MEGA LIFE AND HEALTH INSURANCE COMPANY, THE 03//2006

    husband
    General Lines Agent Life, Accident, Health and HMO 04/2006 04/2008 Active
    MEGA LIFE AND HEALTH INSURANCE COMPANY, THE 04/2006


    guess the guy had to take the test a few times.......but at any rate I thought I would give them a call and find out how it was going and give some pointers .....and ask how serious do they take health insurance .....then this broad she freaks out...and launchs into this we are saving the world nase speech and hangs up on me.....you know man I try........
     
  10. MIBizInsurance
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    MIBizInsurance Guru

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    OMG!

    Here in SE, MI they cover every pole in eye sight with those stupid ass signs.
     

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