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State Farm Agents - Now Selling Obamacare?
- Thread starter sbkarren
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Its a deal between State Farm and HCSC. The blues parent company for those 5 states.
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LGilmore, dude you need to seriously cool a bit. I was putting up some quick examples which are correct, yet not worded air tight. Been busy lately and simply wanted to reply...
I have been doing individual health for 6 years and know exactly what I'm talking about.
BTW: If you're single self employed most people don't buy L&I on yourself, so an injury would not be covered by anyone. Oops.
Some companies process pre-approval faster than others in general (one day to 30 days difference sometimes). One company's producer support answered a question within 2 min...others have much worse customer and agent service for client questions.
Overall my initial point was that if you are ONLY selling one health carrier you are not doing your clients justice (can cost thousands more)...other lines of insurance the premium might be a few bucks more, that's it.
I have been doing individual health for 6 years and know exactly what I'm talking about.
BTW: If you're single self employed most people don't buy L&I on yourself, so an injury would not be covered by anyone. Oops.
Some companies process pre-approval faster than others in general (one day to 30 days difference sometimes). One company's producer support answered a question within 2 min...others have much worse customer and agent service for client questions.
Overall my initial point was that if you are ONLY selling one health carrier you are not doing your clients justice (can cost thousands more)...other lines of insurance the premium might be a few bucks more, that's it.
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BTW: If you're single self employed most people don't buy L&I on yourself, so an injury would not be covered by anyone. Oops.
From Regence small group (1-50) on Workers Comp.... "The provision applies if you had filed or entitled to file a claim for workers compensation benefits for treatment of an illness or injury arising out of or in the course of employment or self employment for wages or profit are excluded under this contract. The only exception would be if the enrolled employee is exempt from state or federal workers compensation law
In Washington, can employers exempt themselves from L&I (workers comp)?
A quick call to the OIC had them saying it is part of the contract carriers provide.
A quick call to Premera small group has the same thing.
I do want to thank you though because you made me look up something I was 99.9% sure about and found through a few phone calls and reading a few contracts that I was 100% sure. You're incorrect, or you've been reading things wrong.
Some companies process pre-approval faster than others in general
Could you provide some names of companies?
The big three turn complete applications in about ten working days or less, if submitted on time. Premera last year with the rollout of small group fell behind by a considerable amount of time, but that was due to the overwhelming amount of new business they picked up by coming out about 25% less in cost for group plans. There was a big rush to Premera by a lot of groups. I actually had renewals under the ACA go down in many cases over the previous year.
Believe me, I am not even close to being harsh on you..... You've come here and posted "stuff" that really isn't so. You've been fluffing yourself up as some sort of wunderkid when it comes to health sales... I'm sorry I could have let it pass, but some of the stuff you stated really ain't so.
Who do you mainly write with? You've made statements about "some" companies and I just want to see if I agree with you or could provide you a better way to find answers.
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Here is Premera's
Work-Related Illness or Injury
This plan does not cover any illness or injury for
which you can get benefits under:
Separate coverage for illness or injury on the job
Workers compensation laws
Any other law that would repay you for an illness
or injury you get on the job
If you're not enrolled, can you get benefits from? Not the best worded compared to Regence but the premera assumes coverage under workers comp.
Premera has since contacted me and sent me
http://app.leg.wa.gov/RCW/default.aspx?cite=51.12.020
which puts them in a yes or no situation depending on how ownership is structured and job duties.
This has been a good learning day. thanks.
From Regence small group (1-50) on Workers Comp.... "The provision applies if you had filed or entitled to file a claim for workers compensation benefits for treatment of an illness or injury arising out of or in the course of employment or self employment for wages or profit are excluded under this contract. The only exception would be if the enrolled employee is exempt from state or federal workers compensation law
In Washington, can employers exempt themselves from L&I (workers comp)?
A quick call to the OIC had them saying it is part of the contract carriers provide.
A quick call to Premera small group has the same thing.
I do want to thank you though because you made me look up something I was 99.9% sure about and found through a few phone calls and reading a few contracts that I was 100% sure. You're incorrect, or you've been reading things wrong.
Some companies process pre-approval faster than others in general
Could you provide some names of companies?
The big three turn complete applications in about ten working days or less, if submitted on time. Premera last year with the rollout of small group fell behind by a considerable amount of time, but that was due to the overwhelming amount of new business they picked up by coming out about 25% less in cost for group plans. There was a big rush to Premera by a lot of groups. I actually had renewals under the ACA go down in many cases over the previous year.
Believe me, I am not even close to being harsh on you..... You've come here and posted "stuff" that really isn't so. You've been fluffing yourself up as some sort of wunderkid when it comes to health sales... I'm sorry I could have let it pass, but some of the stuff you stated really ain't so.
Who do you mainly write with? You've made statements about "some" companies and I just want to see if I agree with you or could provide you a better way to find answers.
----------
Here is Premera's
Work-Related Illness or Injury
This plan does not cover any illness or injury for
which you can get benefits under:
Separate coverage for illness or injury on the job
Workers compensation laws
Any other law that would repay you for an illness
or injury you get on the job
If you're not enrolled, can you get benefits from? Not the best worded compared to Regence but the premera assumes coverage under workers comp.
Premera has since contacted me and sent me
http://app.leg.wa.gov/RCW/default.aspx?cite=51.12.020
which puts them in a yes or no situation depending on how ownership is structured and job duties.
This has been a good learning day. thanks.
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LGilmore, I'm talking about Individual Health, not Small Group Plans.
The quotes you have are specifically for Groups...
The quotes you have are specifically for Groups...
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And small group in WA goes down to how many?
And specifically we're talking self employed?
Have a feeling the definitions are the same, but I will take a look.
But if you saying this is a problem for self employed, I've presented a solution for you to use. Rather than place them in a individual plan, write them as small group and the issue is solved.
A quick glance at individual exclusions leads me to believe they follow the same as group.
And specifically we're talking self employed?
Have a feeling the definitions are the same, but I will take a look.
But if you saying this is a problem for self employed, I've presented a solution for you to use. Rather than place them in a individual plan, write them as small group and the issue is solved.
A quick glance at individual exclusions leads me to believe they follow the same as group.
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I send my small groups to another agent that works with me, so I only directly do Individual plans...mainly to self employed 1 person sole proprietors.
I do appreciate keeping it above board and digging into the details.
I do appreciate keeping it above board and digging into the details.
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RCW 51.12.020: Employments excluded.
I would think at a minimum plans would have to adhere to this state code as they wouldn't be able to reject a state law and it's application.
So those exempt, which includes insurance agents, have 24/7 coverage from their medical plans. Those that would not fit those categories outlined under state law would not have 24/7 coverage unless the carrier granted it. At a minimum the carriers have to comply with the law as written. They can do more, but they can't do less.
I would think at a minimum plans would have to adhere to this state code as they wouldn't be able to reject a state law and it's application.
So those exempt, which includes insurance agents, have 24/7 coverage from their medical plans. Those that would not fit those categories outlined under state law would not have 24/7 coverage unless the carrier granted it. At a minimum the carriers have to comply with the law as written. They can do more, but they can't do less.
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LGilmore - the original conversation was about Individal plans, so I only assumed we were talking about those plans. Apparently we were both right (as you were talking about group plans), lol.
I was 100% correct about Individal plans. Called Premera today and they said if you are self employed and get injured they DO cover the medical expenses, another carrier said the same thing. Only asked two since I talked with them about other issues.
I researched this last year as well and knew they covered it since my dad specifically chose a plan since it covered him while at work.
I was 100% correct about Individal plans. Called Premera today and they said if you are self employed and get injured they DO cover the medical expenses, another carrier said the same thing. Only asked two since I talked with them about other issues.
I researched this last year as well and knew they covered it since my dad specifically chose a plan since it covered him while at work.
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LGilmore - never heard back from you...
P.S. I was completely right about Individal plans covering on the job injuries (except for the one carrier in WA). Just wanted to state to the record here that my original statement was correct.
P.S. I was completely right about Individal plans covering on the job injuries (except for the one carrier in WA). Just wanted to state to the record here that my original statement was correct.
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