Singular Pay Loophole

[Expat]

AFFORDABILITY counts..................BIG TIME

 

[Crabcake Johnny]

No it doesn't. Apparently if your client can't afford "the best" plan or would get declined for the best plan you walk away.

 

[Expat]

Not me, I'm too bloody greedy.

 

[somarco]

There are plenty of ways to make a plan affordable without sacrificing quality of benefits. I do it every day without putting my clients in a crap plan.

Guess that would be what you call selling . . .

 

[Crabcake Johnny]

I'm apparently unethical for selling Carefirst due to the drug cap. I know I'm really commission driven when I kick those plans out - I'm saving all those $17.50's to buy a Porche.

 

[Crabcake Johnny]

There are plenty of ways to make a plan affordable without sacrificing quality of benefits. I do it every day without putting my clients in a crap plan.

Guess that would be what you call selling . . .

Really? Enlighten me then on what advice I should give a client who would be a GR or Assurant flat decline. GR just declined another potential HSA client of mine - on two meds. Can't do Assurant because the rates would be through the ceiling. I'm glued to your advice for this person.

 

[arnguy]

Yeah somarco, please do enlighten us.

 

[K-Dub]

Please be sure to send those articles to Carefirst, Kaiser, Optimum Choice, Aetna and Coventry. They are the one that cap drugs, not me. And if it's a GR and Assurant decline, unlike you, I'm not just hanging my client out in the wind to fend for them self. I can't even imagine the conversation:

Beth, age 62 smoker with HBP 2 meds, no coverage:

Beth: "So what did you find?"

Me: "Unfortunately Beth your choices are limited. Golden Rule won't take you. Assurant would, but the rate would be crazy and I already know you can't go over $250. Coventry would also decline but Carefirst would take you. The downside is the limit on drugs is $500."

Beth: "Well I'll take it, I have nothing now and need coverage."

Me: "Actually Beth you need to find another agent. I simply don't need your business." <click.>

Beth: "Hello? HELLO???"

Beth: "Well I'll take it, I have nothing now and need coverage."

Me: "Actually Beth you need to find another agent. I simply don't need your business." <click.>

Beth: "Hello? HELLO???"

Continuation from telephone conversation:

Beth: "Oh, I have another call coming in, hello?"

Mega Agent: Beth I hear you looking for a plan that limits you in many ways BUT IS AFFORDABLE. I can help you!

Beth: "That would be great!"

Mega Agent: Can we meet this Thursday?

Beth: "Sure!"

I know there are some situations where the client won't be able to afford a plan with no caps and will have to choose something limited, but in most cases (here in CO) I can put the client into a plan that will not screw them should something serious happen. This is where it varies from state to state. Bottom line is if you sell on price along you will eventually lose!

I just wrote a client yesterday who would save about $100 a month with an Aetna plan, but would most likely get declined, so I wrote her on a plan with World which is more but will accept. There is so much involved in regards to underwriting I think it is why most new agent fail, aside from not prospecting.

Let me give you a scenario, answer honestly. Let's say a client wants to buy a health plan and tells you they want the premiums no more than $250 a month. You price it out and find that a limited plan is $245 which caps drugs at 5k a year, and a non limited plan with no Rx cap is $280 what do you do?

Depending on your answer will determine if you are selling on price or benefits. I guarantee I would get the client on the non limited plan for $280, if not I'd walk away!!

 

[Crabcake Johnny]

Apparently we don't get a answer about GR and Assurant declines as to where to put them. I guess some agents could say "Get a job with benefits....click." In MD there's no group of one options which would be neither here nor there when I get referrals like my last one - dental assistant making $30,000 a year - on meds, no plan at work. She deserves an agent like everyone else - not "I'm too successful to deal with you."

 

[Crabcake Johnny]

Beth: "Well I'll take it, I have nothing now and need coverage."

Me: "Actually Beth you need to find another agent. I simply don't need your business." <click.>

Beth: "Hello? HELLO???"

Continuation from telephone conversation:

Beth: "Oh, I have another call coming in, hello?"

Mega Agent: Beth I hear you looking for a plan that limits you in many ways BUT IS AFFORDABLE. I can help you!

Beth: "That would be great!"

Mega Agent: Can we meet this Thursday?

Beth: "Sure!"

I know there are some situations where the client won't be able to afford a plan with no caps and will have to choose something limited, but in most cases (here in CO) I can put the client into a plan that will not screw them should something serious happen. This is where it varies from state to state. Bottom line is if you sell on price along you will eventually lose!

I just wrote a client yesterday who would save about $100 a month with an Aetna plan, but would most likely get declined, so I wrote her on a plan with World which is more but will accept. There is so much involved in regards to underwriting I think it is why most new agent fail, aside from not prospecting.

Let me give you a scenario, answer honestly. Let's say a client wants to buy a health plan and tells you they want the premiums no more than $250 a month. You price it out and find that a limited plan is $245 which caps drugs at 5k a year, and a non limited plan with no Rx cap is $280 what do you do?

Depending on your answer will determine if you are selling on price or benefits. I guarantee I would get the client on the non limited plan for $280, if not I'd walk away!!

Now help me with a smoker with HBP:

Aetna - out of the park
GR - declined (as of last week - lied to me yet again, said "no problem.")
Assurant - astronomic rates
Coventry - decline
Kaiser - decline
Carefirst - will absolutely accept - 9 month wait on pre-ex, $500 cap on meds, in her price range.

So unless I'm missing something (and she's a referral from a friend) I tell her to either pound sand, quit her job or sell Carefirst.