North Carolina Health Companies

[J.R.]

I've been an indpendent agent here in NC since 2001. As already mentioned, North Carolina is a tough state for ethical agents to sell in if they aren't appointed with BCBSNC. I've seen in other states where the blues aren't good companies or plans. Neither is true here. BCBSNC goes above and beyond for there members here. Not to mention the benefit levels and the most fair (no riders, etc.) underwriting, they simply can't be beat for 90% of applicants. I still offer other carriers as well, but they rarely fit the need of the client.
The only caps they have on rx's is for name brand. Even then, there is a catastrophic clause in the contract that gives coverage for drugs that are of higher cost.
Golden Rule is usually my second carrier with Assurant. Hope this info helps.

Thanks for the the info. Were you able to see a specimen contract of their policies?

 

[schoolofhardknocks2]

Thanks for the the info. Were you able to see a specimen contract of their policies?

I have the policy that covers my family.

 

[J.R.]

Good stuff.

 

[arnguy]

In PA, Independence Blue Cross (Philadelphia and the 4 contiguous counties) did not open up the market to brokers until around 1990. Before that everything was written direct by their in-house sales force. I don't know the situation with the other blues in this state.

 

[newmindfashion]

SchoolOfHardKnocks2...

Please explain the 2K cap on brand name medications. How exactly does it work in the context of this "catastrophic clause" where they will pay for more expensive drugs.

Why is there a cap then and how does it function?

 

[newmindfashion]

HardKnocks2,
The reason I'm curious is I just got licensed in NC recently to help a friend there and they were almost ready to do the 10K HSA w/ BCBSNC after I told them it was available through some local agents but they were very wary of the 2K cap on brand meds so went with Assurant using the MedCost network.

If the Assurant underwriting doesn't work out for them, I would like to be able to explain this catastrophic clause on brand meds.

Any advice would be helpful.

 

[schoolofhardknocks2]

HardKnocks2,
The reason I'm curious is I just got licensed in NC recently to help a friend there and they were almost ready to do the 10K HSA w/ BCBSNC after I told them it was available through some local agents but they were very wary of the 2K cap on brand meds so went with Assurant using the MedCost network.

If the Assurant underwriting doesn't work out for them, I would like to be able to explain this catastrophic clause on brand meds.

Any advice would be helpful.

Hi newmindfashion, Sorry for the delayed response. Rx's that cost more than $500/30 day supply are not subject to the $2000 ann brand name max and is stated very prominently in the summary of ben page of the policy.

Your friends more than likely would be better served by BCBSNC's HSA for the following reasons...
*Better in network discounts and repricing than Medcost
*Preventive care/immunizations covered @ 100% with no ded, no waiting period, & no annual max
*Unlimited Lifetime Policy Max
*Much lower rates
*I know of many stories where BCBSNC goes above and beyond what they are contractually ogligated to do when major illnesses and claims occurr. As far as my family goes, if we ever do have any major health issues, this is the company I'd want to be with.

Hope this helps... let me know if I can help you with anything.

 

[Guest]

Hi schoolofhardknocks2. I'm a newbie, just curious, what are the renewal rates for BCBSNC for the last couple or three years? Thanks!

 

[schoolofhardknocks2]

Hi schoolofhardknocks2. I'm a newbie, just curious, what are the renewal rates for BCBSNC for the last couple or three years? Thanks!

2007 = 5-6% avg with my clients...some actually took a decrease
2006 = 10-13% avg with my clients
2005 = 8% avg with my clients

These are aprox and not exact, but are a good ballpark. I don't think any of the HSA's took a rate increase in 2007. On a side note, renewal business is rated the same as new business. I wish all carriers were like that.

 

[thackeragency]

My family has represented Blue Cross of NC since the mid 70's. I agree with 'school of hardknocks' that BCBSNC has been dominant for the past 10 years or so. But their individual rates have increased 100% in the last 6 years. They did reduce the rates on some of their Plan B Blue Advantage plans last year, AND they offered FREE GENERIC DRUGS for the past year on their plans. BCBSNC has been good and continues to be a good plan for NC and the residents of NC.

Having said that, Golden Rule only came into NC in November because they could not compete and make money for their shareholders before then. BCBSNC had no competition at all until recently. Assurant has been here, but hasn't been prevalent. The Golden Rule product through United Health is actually pretty good and getting better. Celtic also has a good product, and Humana has recently come in with a product. BCBSNC basically owns the NC legislators and that is one reason it is difficult for competition to come into the market. They are still 'non-profit', but they pay taxes and operate as a 'for profit' company.

BCBSNC has just recreated their agent contract to force agents to be 'exclusive' with BCBSNC for the first time ever. They have good plans because they have a ton of cash (1 billion in reserves for ONE state). They are a 4 billion dollar a year company.

Having said all of this BCBSNC IS afraid of new competition. They won't be able to raise their rates like they have because of the competition. I would bet that the rate increases for Jan 1 will be between 10 and 20%. Blue Cross is an excellent plan, but now there is competition available only BECAUSE BCBSNC raised their rates so much.

I still like and represent BCBSNC, I'm just stating info from my own point of view from the state of NC. United Health (Golden Rule), Celtic, Assurant, Humana all have new good programs to compete with BCBSNC in NC.