Next OEP - Clawback / Income Projection NIGHTMARE

[RayNY]

Somarco,

We have the responsibility, at least for the clients we assisted this year. Passing them to a navigator doesn't solve the problems incurred between Day 1 and next OEP.

Its still your license on the line when they decide to sue for breach of fiduciary responsibility, or whatever they decide to pursue you for after failing to advise.

(I know you're making the suggesting in jest, because no one with a working brain would send another human to a navigator.)

 

[Ann H]

(I know you're making the suggesting in jest, because no one with a working brain would send another human to a navigator.)

Somarco has a very dry sense of humor.

 

[VolAgent]

Somarco,

We have the responsibility, at least for the clients we assisted this year. Passing them to a navigator doesn't solve the problems incurred between Day 1 and next OEP.

Its still your license on the line when they decide to sue for breach of fiduciary responsibility, or whatever they decide to pursue you for after failing to advise.

(I know you're making the suggesting in jest, because no one with a working brain would send another human to a navigator.)

Ray, maybe things are different in New York, but in the rest of the states, having an insurance license doesn't make you a fiduciary. Please do yourself and all other insurance agents a favor and stop referring to yourself as one.

 

[Ann H]

Of course, New York has the most brutal DOI enforcement in the nation!

 

[RayNY]

I know we're not fiduciaries, the point is, they will sue (or threaten to sue) for anything, even if it's completely wrong.

How many times have you seen cases go to court where the plaintiff is obviously wrong or going to lose? How many times where they cite the wrong violation, refer to the wrong law, or even pursue the wrong party?

Yes, it might be thrown out or settled, do you really want your name/face/agency in the headlines? It's not beyond an irate client to destroy your reputation even if they can't win in a court of law.

 

[somarco]

Actually Ray, I am not kidding. I won't touch a subsidy eligible individual with a 10 foot pole. I only write off exchange business. Don't need the hassle. If someone wants a subsidy, or thinks they are eligible, I send them to healthcare.flub and tell them to come back when they are frustrated.

 

[Guest]

I have done the same thing Somarco, not putting my name on that crap of confusion.

 

[FLM2]

I just hit double digits on exchange business this week. Thank goodness!!!

I've now hit double digits on turning down Exchange business and have written 5 of them without a single penny of commission being paid as of today.

I also had 10 people come out of the woodwork last week and do Off Exchange policies, the average premium was $1K and it will all get paid out in April at much higher levels of comp than anything on the Exchange.

I haven't been working much for the past 3 months but still did 20 Off Exchange policies-my whole business effort for the rest of the year will be during the next OEP maintaining my new book of business (I'm anticipating having to rewrite almost everyone as it's doubtful Assurant will stay competitive for 2015 after their claims data is analyzed).

 

[Yagents]

(I'm anticipating having to rewrite almost everyone as it's doubtful Assurant will stay competitive for 2015 after their claims data is analyzed).

I spoke to my contact and claims are in line with what they projected initially, and off exchange plans ARE eligible for the reinsurance pool of money. So, hopefully there won't be any nasty surprises.

 

[AllenChicago]

April 1, 2014

Latest study and projection. I hope none of our esteemed forum members goaded applicants to under-estimate their 2014 income.

1.) Approximately 40% of subsidy recipients will need to send a check TO the U.S. Treasury, because too much subsidy money was sent to their insurer in 2014.

2.) Approximately 40% of subsidy recipients will receive a check FROM the Treasury, because too little subsidy money was sent to their insurer in 2014.

Good Article that describes how the subsidy clawback/repayment aspect of the Affordable Care Act has been "adjusted" (to the recipient's detriment) twice, by Congress, since 2010.

Story: Are ObamaCare's Tax Credits Harmless? The Little Understood Dark Side Of The Subsidies - Forbes

I bet those who have a reduction in income, or an increase in family size will have the best memory for diligently reporting their "life change" to the marketplace. Consequently, the study's estimate of 40% is probably too high for those who will receive an APTC/Subsidy check from Uncle Sam next year.
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