Relocation and agent license question

New York might have the screwiest insurance laws in the country,1. Since all group health insurance is gi and community rated,

What is 'community rated'? Is that having different rates for each zip code like CA has?


it is very easy to identify which types of policies can be easily replaced.

Can you explain this. I'm lost.


In addition, you don't need to pre-certify anyone before offering them a fully mature quote, which takes away like 80% of the hassle of selling group health insurance.

I've not done any replacement groups, only new (3-5 person) groups. What is pre-certify?


2. By and large, individual health insurance is not a broker product in NY. I believe that a majority of carriers will only write direct.

Do you mean there are few or no agents? People buy direct from the Blues, etc.? Can the carriers handle that kind of sales volume?


2. A much higher % of the life and annuity agents in NY are with captive companies (The % is much lower elsewhere in the nation) ,

I don't doubt you, I'm just wondering where you came up with the numbrers to suppport the statement. Why would New York have a higher % of captives?

Thanks,

Al
 
Hey Chumps, Temple U. is my alma mater. The main campus has improved quite a bit in recent years. They have two suburban campuses in the Philly area. Also, BKrocko, I live across the highway from Arcadia University (formerly Beaver College) and they are expanding all over the Glenside and Wyncote areas of Cheltenham Towndhip. BTW, Arcadia has been co-ed for anumber of years.:)
 
1. In NY, for group health, the rates are based solely on the zip code that the person lives in. Health status and AGE do not factor in. Which means that the rate is the exact same for a group with an average age of 50 as a group with an average age of 30.

2. All you need to do is scan a few zip codes a day and look for a company that is significantly cheaper for a similar plan. Since the plans are heavily regulated, a 10/20 HMO with Aetna will be almost the exact same plan as with Oxford. Therefore, if one is 10% less in a zip, then you call all the companies in that zip and ask which they have and it is easy to pick off the rest.

3. In many states, when quoting group health insurance, you need to get them to fill out a health questionnaire and the actual final rates may be 5-500% higher than what you quoted them in the beginning. As you know, Cali has a 10% possible spread, meanwhile, Arizona can go up 400%. In NY, as in other guaranteed issue states, you know that what you quote them will stick and you won't lose a case to a hip replacement.

4. Several of the carriers, including Blue will not write through agents. Since indy insurance is also GI, and community rated, it is virtually impossible for the carriers to make money on it, because of the heavy adverse selection, so they have no incentive to sell it actively. If you want it, you have to go direct to them.

5. Since there is a limit on commission paid in NY, it can make more sense to be captive. In addition, being the home base of several of the biggest captive companies, they have a very large presence there.
 
1. In NY, for group health, the rates are based solely on the zip code that the person lives in. Health status and AGE do not factor in. Which means that the rate is the exact same for a group with an average age of 50 as a group with an average age of 30.

OK, but how does this affect the agent? I'm not arguing, just wondering.

2. All you need to do is scan a few zip codes a day and look for a company that is significantly cheaper for a similar plan. Since the plans are heavily regulated, a 10/20 HMO with Aetna will be almost the exact same plan as with Oxford. Therefore, if one is 10% less in a zip, then you call all the companies in that zip and ask which they have and it is easy to pick off the rest.

Yes, but if as you say the major health carriers won't write through agents, who is going to do the above (scan/cherry pick) Who would want to be a health agent?


3. In many states, when quoting group health insurance, you need to get them to fill out a health questionnaire and the actual final rates may be 5-500% higher than what you quoted them in the beginning. As you know, Cali has a 10% possible spread, meanwhile, Arizona can go up 400%. In NY, as in other guaranteed issue states, you know that what you quote them will stick and you won't lose a case to a hip replacement.

Yes, CA has a rate adjustment factor (RAF) of from .90 to 1.10. Every small group automatically gets a 10% rate-up. That's the price they pay for getting G.I. health care. No one seems to make a big deal about it... assuming they can afford the adjusted rate.


4. Several of the carriers, including Blue will not write through agents. Since indy insurance is also GI, and community rated, it is virtually impossible for the carriers to make money on it, because of the heavy adverse selection, so they have no incentive to sell it actively. If you want it, you have to go direct to them.

You are saying that individual and family plans are GI in New York? I didn't know that. I thought only in Mass. this was the case. So if Blue Cross is the major player (is it?) then you are saying it is a waste of time to try to be a health agent in NY? If so, good thing I'm looking at annuities.

5. Since there is a limit on commission paid in NY, it can make more sense to be captive. In addition, being the home base of several of the biggest captive companies, they have a very large presence there.

Limit on commission? For life, annuities, and LTC too? Where is this written. (Again, not doubting you, just trying to find the data.) What is the limit? How does it compare to states without a limit? Is there a limit for fee-based financial advisors?

From what you imply, it seems a waste of time to go into the insurance biz as an agent in New York. Is that true? Tell me now, PLEASE! New York City is full of opportunities.... I can sell anything... I used to sell nickel bags... could do it again... probably more profit and less risk!!

Al
 
Hey Chumps, Temple U. is my alma mater. The main campus has improved quite a bit in recent years. They have two suburban campuses in the Philly area. Also, BKrocko, I live across the highway from Arcadia University (formerly Beaver College) and they are expanding all over the Glenside and Wyncote areas of Cheltenham Towndhip. BTW, Arcadia has been co-ed for anumber of years.:)

LOL arnguy - I'm aging myself, it's been a "number of years" since I've been there. The thing I miss most is a real Philly cheese stake (for those that would think otherwise, its not Pat's or Geno's).
 
1 and 2 are discussing group health, which can be sold by agents. It is individual which is almost exclusively direct.

3. This is also discussing group. In Cali, the 10% is really not a big deal. When you run quotes, you can just price it in. However, in most states, selling group is more difficult than this, because of the potential rate up factor. In NY, it is non-existent. Additionally, you don't even need a real census to give quotes, because they don't care about age.

4. Correct, it is GI and is not really possible to make a living selling individual health insurance there. http://www.healthinsuranceinfo.net/ny00.html
You cannot be turned down for an individual health insurance policy because of your health status, age, or any other factor that might predict your use of health services. This is called guaranteed issue (see page 21).

If you are buying an individual health insurance policy, you cannot be charged more for your health insurance due to health status, age, gender, or occupation. This is called community rating (see page 13).

5. http://www.insurance-forums.net/forum/showthread.php?t=1574 esp # 8 and on.
I don't know that this is true for ltc. However, I do know that several of the companies that write SPIA's in NY pay less than the standard 4%
 
Al,

I guess I've been watching too much TV. When I saw the title of the thread the first thing that came to mind when I read the word "relocation" was the Witness Protection Program.

I'm glad to see that "they are not out to get you". :D

I've got to go with BKrocko on this one. I wouldn't ever go back to Chicago. I love the outdoors too much.
 
Hey Bkrocko, this is Pennsylvania not Transylvania (referring to the cheese stake (sp.), of course.:D Anyway, I think Jim's on South Street has the best cheesesteaks. Pat's require a bib while eating it----depends on whether you want it "wid" or "widout" (Cheese Wiz for the foreigners). Geno's created a big flap a few months ago when he posted a sign that stated, "This is America - Order in English." The Hispanic community was up in arms and City Hall got involved through the Human Rights Commission. I don't know if he (Geno) finally relented and took down the sign.:skeptical: As they say in South Philly, youse guys gotta have a cheesesteak sanwhich!:cool:
 
We actually don't want to live there year round. We want a residence so we can go up whenever we want. A good hotel there is $350 a night and trust me, you do NOT want to stay in one that charges less than that.

When I go to manhattan I stay on the other side of the bridge for $125/night nice Marriot and only 15 minutes to A train via $1 shuttle.
 
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