United/Golden Rule

[moonlightandmargaritas]

The FL DOI is not a fan of association-based coverage and every certificate comes with a warning:

So what? In the consumer's mind it's a non-issue.

If you actually lived and worked here as I do, you'd know that the Florida DOI has absolutely no credibility with anybody, generally due to the homeowner's insurance mess that they've ****ed up beyond comprehension.

In addition, the marketplace regulates the premiums far more efficiently than any DOI could ever hope to.

 

[Crabcake Johnny]

Oh....I agree with you!

The DOI is obviously in the tank for BX down there. I find that notice to be insulting.

In MD the worst rate increase has been Aetna - non-association. GR has been by far the best.

 

[moonlightandmargaritas]

The DOI is obviously in the tank for BX down there.

Blue just got a 11% increase effective today. Their beauty is that they hold it to once a year.

GR will raise premiums every six months after the first year. Renewals have been about 15% lately.

 

[Crabcake Johnny]

It is often taught that domiciled carriers offer more protection since rate increases need DOI approval. However, in MD when the DOI approves anything I haven't seen the difference.

Aenta's increases have been abusive and out of control - yet the DOI approves them. Association-based is "warned against" by the DOI yet I have not seen rates increase that are out of line.

I do think FL has a bad taste in their mouth over American Republic blocking sick people together and rating them off the books some years back - do which the FL DOI sued them and AR stopped using that business practice.

 

[Senateguy]

Association health plans don't abide by state mandates.
They don't cover the mamogram like a state plan does.
Your recourse with respect to claims is very limited because your health policy is not held by you, its held by the association.

Believe me, they didn't go through the long winded drama of creating those bogus associations to route the health plan through if it wasn't in their best interest.

Its all about regulation. They don't want anything to do with it.

 

[moonlightandmargaritas]

Association health plans don't abide by state mandates.
They don't cover the mamogram like a state plan does.

Man, you're some kind of joker.

Lemme get this straight...you supposedly have 200+ GR policies on the books, and you're in Florida?

God help your clients, if you truly have any.

If you actually read one of the policies, you'll find all the state mandated benefits (including a mammogram without having to meet the deductible) are in fact included.

Of course you didn't know what "admitted" meant either...

 

[Senateguy]

Acutally you are a total ***.

Only one plan offered by Golden Rule covers the mamogram pre-deduticble and thats the copay plus plan. And it covers the mamogram at 80% you freakin ***. Not the state mandated 100%. And Golden Rule just came out with that plan about a year ago

The HSA - the Plan 100 - and any of the other saver plans do not cover the mamogram before the deductible as required by the state

I don't even know why I address your *** self.

You haven't a clue what you are ever talking about.

 

[moonlightandmargaritas]

Only one plan offered by Golden Rule covers the mamogram pre-deduticble and thats the copay plus plan. And it covers the mamogram at 80% you freakin ***. Not the state mandated 100%. And Golden Rule just came out with that plan about a year ago

The HSA - the Plan 100 - and any of the other saver plans do not cover the mamogram before the deductible as required by the state

From the Golden Rule Florida Plans brochure, under HSA100 (and Saver too!):

"Preventive mammogram, pap smear, PSA testing - 100%. Deductible may NOT apply in accordance to Florida state law."

Have a look: https://www.goldenrulehealth.com/PDF/36702L07.pdf

Here's a clue for you: a mammogram doesn't have to covered at 100% under Florida statute. It has to be covered with no deductible.

How long have you had a Florida insurance license? You're the kind of guy that gives the insurance business a bad name. Your ignorance is remarkable.

Who's the "freakin' *** moron" now?

 

[Senateguy]

No your wrong. And the statement says "may."

Why don't you call up the broker service center and ask them if the mamogram is covered on the HSA pre-deductible??

1-800-474-4467.

And Golden Rule had a 1 year wait on preventive care for pretty much all their health plans with the exception of the HSA until 10 months ago.

I don't even know why I argue with you.

The mamogram is not covered pre-deductible on the HSA. It is covered at 80% on the copay plus plan, but the co-pay plus plan has a MAXIMUM benefit of 300 bucks. ANd the co-pay plus plan just came out about 10 months ago

BCBS covers the Mamogram at 100% on ALL OF ITS PLANS! It covers the pap and annual check up 100% on just about all its plans -- the benefit max varies between 150 bucks and 250 bucks depending on which plan you have.

Humana covers the mamogram at 100% on pretty much all its plans.

Avalon Health Care covers the mamogram on all its plans>>

WHY?? Because its MANDATED by the state!

and its mandated that it is covered at 100%

You are a total freakin *** that just spews total and utter non-sense.

 

[Senateguy]

And as for your other stupid comment about the mammogram not being required to be covered at 100%...

Call me when you get a clue.. And read up chappie.

---------

The 2006 Florida Statutes

Title XXXVII
INSURANCEChapter 627
INSURANCE RATES AND CONTRACTSView Entire Chapter
[SIZE=-1]627.6418 Coverage for mammograms.-- [/SIZE]
[SIZE=-1](1) An accident or health insurance policy issued, amended, delivered, or renewed in this state must provide coverage for at least the following: [/SIZE]
[SIZE=-1](a) A baseline mammogram for any woman who is 35 years of age or older, but younger than 40 years of age. [/SIZE]
[SIZE=-1](b) A mammogram every 2 years for any woman who is 40 years of age or older, but younger than 50 years of age, or more frequently based on the patient's physician's recommendation. [/SIZE]
[SIZE=-1](c) A mammogram every year for any woman who is 50 years of age or older. [/SIZE]
[SIZE=-1](d) One or more mammograms a year, based upon a physician's recommendation, for any woman who is at risk for breast cancer because of a personal or family history of breast cancer, because of having a history of biopsy-proven benign breast disease, because of having a mother, sister, or daughter who has or has had breast cancer, or because a woman has not given birth before the age of 30. [/SIZE]
[SIZE=-1](2) Except as provided in paragraph (1)(b), for mammograms done more frequently than every 2 years for women 40 years of age or older but younger than 50 years of age, the coverage required by subsection (1) applies, with or without a physician prescription, if the insured obtains a mammogram in an office, facility, or health testing service that uses radiological equipment registered with the Department of Health for breast cancer screening. The coverage is subject to the deductible and coinsurance provisions applicable to outpatient visits, and is also subject to all other terms and conditions applicable to other benefits. This section does not affect any requirements or prohibitions relating to who may perform, analyze, or interpret a mammogram or the persons to whom the results of a mammogram may be furnished or released. (3) This section does not apply to disability income, specified disease, or hospital indemnity policies. (4) Every insurer subject to the requirements of this section shall make available to the policyholder as part of the application, for an appropriate additional premium, the coverage required in this section without such coverage being subject to the deductible or coinsurance provisions of the policy.[/SIZE]