Singular Pay Loophole

[blaze1x]

Better darned well contact the carriers with those clauses and find out the scoop. If you run around telling clients falsehoods about the competition that's no only unethical but opens you up for a lawsuit. In the case of Carefirst it's a non-issue if it's in network. If you're having a major surgery out of network it's neither her nor there since you're screwed with any company.

If you have Assurant managers telling you to trash talk the competition I'd walk off that job in a day. Sitting down with clients and whipping out "competitors" plans and trashing them is no way I'd want to make a living.

I sort of agree with you, but Golden Rule is only able to operate in fourteen states. You can tell this from just looking at their home page. Humana cancelled 50000 clients four years ago in the state of Florida. Their plans also don't have Max Out of Pockets. We personally have a friend who got hit in the wallet over the singular pay loophole with Blue Cross. Blue Cross also has an incidental clause where they state that if you have a hysterectomy and during the course of that surgery your appendix is removed, the incidental surgery is not covered. This is not trash talk, it's right there in the policy (including the example explaining what incidental surgery is). I'm saying all this to insurance salesman, so believe me when I say there's no rhetoric intended. I just want to hear what people who don't work for my company have to say about these clauses. Incidentally, when I make a presentation I actually have a copy of all the policies with me--it's part of the training.

 

[Crabcake Johnny]

What state are you in? And I can only hope you're being trained to only sell Max Plan and HSA.

 

[blaze1x]

What state are you in? And I can only hope you're being trained to only sell Max Plan and HSA.

Florida. And yes, we're only allowed to sell HSA, Max Plan and CoreMed.

 

[Crabcake Johnny]

Golden Rule kicks Assurant's ass in FL on rates. Also, what's your problem with World?

 

[somarco]

You must not be aware of the "gotcha's" in the Core Med.

I can make any plan with any carrier look good . . . but I choose not to. The only plans that are offered are those that I would buy for my family.

If you want to ride one horse, that is your prerrogative. But when you run up against someone that has their clients best interest at heart, and offers multiple plans with different carriers, you will lose.

Seems to me you spent way too much time with Mega, learning how to sell against the plans you now offer. Old tricks are hard to shake off. Negative selling is not a formula for success.

 

[Crabcake Johnny]

I can't bash CoreMed at all. CoreMed's been responsible for getting a lot of clients insured when they had nothing and no other company would take them. CoreMed is "the best worst" plan available on the entire market.

And truth be told, if there has to be a captive health insurance agency out there then Assurant's the best way to go. Could never pull it off with any other company due to strict underwriting. GR is great....and they just declined a HSA client 5 pounds overweight with HBP on one med.

The other carriers can be great for people who don't have pre-ex. Assurant is still king of the country for people on meds or who are less than healthy. In GA they might not be since they don't offer all the underwriting decisions available. But that's GA specific - in other states although the rates are higher they still take clients other companies won't touch.

All of us can get on our high horses a bit much. EVERYTHING is captive! All agency owners for State Farm, Allstate, Nationwide, etc...are all unethical? Last time I checked if you walk into a State Farm office you can only buy Assurant for heath and State Farm products for auto, life and homeowners. Does that mean State Farm has to offer the BEST rates and BEST products or they're whores? Hell no!

I personally would never be captive - however just realize that independent does not work as a business model. If it does please show me a name brand national independent agency.

Business in general is captive. You work for Apple then you work for Apple. Does it mean you're a whore if Apple doesn't have THE BEST products? Hell know. Even sales reps on 1099 are captive in very single industry from medical sales to home improvements. I never never in my life seen a higher failure rate in anything then being an independent insurance agent. All working successful local agencies in my area are all captive.

 

[blaze1x]

You must not be aware of the "gotcha's" in the Core Med.

I can make any plan with any carrier look good . . . but I choose not to. The only plans that are offered are those that I would buy for my family.

If you want to ride one horse, that is your prerrogative. But when you run up against someone that has their clients best interest at heart, and offers multiple plans with different carriers, you will lose.

Seems to me you spent way too much time with Mega, learning how to sell against the plans you now offer. Old tricks are hard to shake off. Negative selling is not a formula for success.

If you're not talking about the four doctor visits, or the mental nervous, or the 50% copay plus $25 for non-generics, then please inform me. Seriously. We're required to remove facility fees when giving quotes. As for the negative route, it's got nothing to do with mega. It's just how my business company does its presentations. I'm explaining loopholes to this forum, not to knock those plans necessarily, but to find out if anyone else has had a client run into those issues. Personally, I can't afford Assurant. My wife has a group plan at her job and at the first of the year we're going to try out hardest to get on her plan without having to pay the 8k/year group rate amount. Her success this year may give us a little leverage with respect to that.

As far as I'm concerned health plans either have the loophole problems or they don't. I think it's my responsibility as an agent to lay those things out to my client. However, and this is important, if they're not issues they need to be worried about, then I'd like to know that and that's what prompted my question in the first place. And guys and ladies, I've been doing this about three months. I recognize that I don't know everything. That's why I'm asking these questions.

Lastly, I never worked for Mega. I came damn close. I almost started a training sessions, but that's as close as I got. Honestly.

 

[blaze1x]

Golden Rule kicks Assurant's ass in FL on rates. Also, what's your problem with World?

World? I'm not familiar with them I don't think.

 

[Crabcake Johnny]

Hey, listen - if you're new in this biz it's been agreed upon that being captive to start is the best way to go - then later you can move to independence. And if you're gonna be captive selling health there's no better company than Assurant. Not the best rates - which is neither here nor there if a good plan fits into your client's budget.

In the FL market it's Assurant, GR, GTL, World, Humana, UA and Blue Cross. I can see why your Assurant GA wants to keep you away from Blue Cross - they are captive in FL and pay 20% commission.

 

[blaze1x]

Hey, listen - if you're new in this biz it's been agreed upon that being captive to start is the best way to go - then later you can move to independence. And if you're gonna be captive selling health there's no better company than Assurant. Not the best rates - which is neither here nor there if a good plan fits into your client's budget.

In the FL market it's Assurant, GR, GTL, World, Humana, UA and Blue Cross. I can see why your Assurant GA wants to keep you away from Blue Cross - they are captive in FL and pay 20% commission.

Thanks for the advice.