TX health agents, what to do?

Jan 25, 2008

  1. HomeService
    Offline

    HomeService Guru

    Posts:
    2,075
    Likes Received:
    41
    State:
    Texas
    What do TX health agents do about this? The co. I work for now has a health plan that states, something like ... "no benefits while on the job..." { except owner and partners, no coverage for workers while on the job}

    Now, I have lived in other states where workers comp is mandatory, but here it is not. So, in other states, the agent can just say, "You have workers comp for that..." if the question ever comes up. Here, it is doubtful they have workers comp, very few employers do- right now.
    I have seen other major meds and limited benefit plans, besides my co., that say "no on the job coverage". { I am paraphrasing, they are worded in different ways. }

    But, here at my co., the question does not come up but I think it may at some point. All of my company brochures show claim examples of " child: broken leg playing on slide in back yard".....that type of examples.

    OK, now I have a 24 hr accident plan that covers on or off the job, for $2500. I do not know what to do about a $100K claim, due to some serious injury. Business owners in TX are taking a risk by simply hiring folks.
     
  2. STIBROKER
    Online

    STIBROKER Like My post and enter the DRAWING,,,, Moderator

    Posts:
    10,550
    Likes Received:
    545
    State:
    Texas
    sell them unicare.....it covers on the job sickness and illness......
     
  3. Brad Howard
    Offline

    Brad Howard Expert

    Posts:
    53
    Likes Received:
    0
    HomeService,
    I'm here in Texas and used to work at the Dept of Ins. A phone call to them should clear this up. The regs are posed online too, so you could take time and read them yourself - though certain death might occur doing this - so a call and clarification might prove best or just go to unicare as STI says.............
     
  4. HomeService
    Offline

    HomeService Guru

    Posts:
    2,075
    Likes Received:
    41
    State:
    Texas
    I have read the regs on workers comp, the business owner actually has to opt out of workers comp and such, but few ever pay attention to that, but that does not help me with what my health ins co { that I sell for} , says about no coverage on the job.

    However, the unicare thing, I did not know they were 24hr coverage. interesting. So, if some agent comes along, and replaces unicare, with a limited benefit plan with no on the job covereage, that agent just did a boo boo. Basically. Very interesting.
     
  5. STIBROKER
    Online

    STIBROKER Like My post and enter the DRAWING,,,, Moderator

    Posts:
    10,550
    Likes Received:
    545
    State:
    Texas
    just read the limitation and exclusions on all the policy's.....some say they will not cover work related injury's and sickness and others say they will let workman's comp pay if liable ....thats why I always ask what they do for a living....if it is a high risk I.E. construction I will recommend for a few dollars more is in their best interest .....I know Aetna does not cover WRS&I........

    [​IMG]
     
    Last edited: Jan 25, 2008
  6. fostever
    Offline

    fostever Guru

    Posts:
    327
    Likes Received:
    7
    Unicare has 24hr work related coverage? Is that an additional rider? I thought they excluded work related injuries.
     
    fostever, Jan 25, 2008
    #6
  7. STIBROKER
    Online

    STIBROKER Like My post and enter the DRAWING,,,, Moderator

    Posts:
    10,550
    Likes Received:
    545
    State:
    Texas
    did you not read the above post...

     
  8. fostever
    Offline

    fostever Guru

    Posts:
    327
    Likes Received:
    7
    "For a few dollars" more was refering to a Unicare rider?
     
    fostever, Jan 25, 2008
    #8
  9. TXINSURANCE
    Offline

    TXINSURANCE Guru

    Posts:
    3,858
    Likes Received:
    28
    There is no rider it comes that way

    What will be ridered is everything pre ex.
     
  10. HomeService
    Offline

    HomeService Guru

    Posts:
    2,075
    Likes Received:
    41
    State:
    Texas
    sti: you posted aetna or unicare up there^^^? if that is unicare, looks like work related stuff is excluded, whether claimed or not???? see where the questions may arise?
     
Loading...