- 1,737
The STM $1,000,000 per 3 month period policy will pay, as listed under limitations:
For intensive care the policy will pay a maximum of 3 times the provider's semi-private room rate.
In addition, the network rate is not guaranteed, nor is there a guarantee of direct claims filed to the insurer from the network listed provider. Save a bunch of money up front, chance of even bigger headaches later. And I get complaints from ACA clients about claims, not often, but still.
Any experience with the Swiss Cheese involved in claims with this sort of policy language? This is not unlike insurance "back in the day".
Agents really have to work at explaining this is not 100% paid after the deductible, the way it mostly is with ACA compliant coverage for in network coverage. Sheesh. Feel like I need them to have a claims lawyer review the policy with the client before signing.
No wonder the premium is 80% lower than ACA coverage.
For intensive care the policy will pay a maximum of 3 times the provider's semi-private room rate.
In addition, the network rate is not guaranteed, nor is there a guarantee of direct claims filed to the insurer from the network listed provider. Save a bunch of money up front, chance of even bigger headaches later. And I get complaints from ACA clients about claims, not often, but still.
Any experience with the Swiss Cheese involved in claims with this sort of policy language? This is not unlike insurance "back in the day".
Agents really have to work at explaining this is not 100% paid after the deductible, the way it mostly is with ACA compliant coverage for in network coverage. Sheesh. Feel like I need them to have a claims lawyer review the policy with the client before signing.
No wonder the premium is 80% lower than ACA coverage.