Unsubsidized health insurance consumers turning to short-term coverage, new report finds

[Brian Anderson]

Brian Anderson submitted a new article

Unsubsidized health insurance consumers turning to short-term coverage, new report finds

Open Enrollment Half-Time Report: About 7 of every 10 people buying coverage at eHealth during the current 2019 open enrollment period are selecting short-term plans, according to new report from the company, up 14% from the same period a year ago.

Continue reading the Original Article.

 

[AllenChicago]

Several states have restricted or totally eliminated Short Term Health plans.

Illinois gave insurers 5 hours advance notice on December 7th, that 1 Year STM's could no longer be sold. Now limited to 6 months, with a 60-day gap required between STM plans.

ACA/ObamaCare is a disaster for our industry and for millions of Americans.

 

[Newby]

I’ve been pitched some of these short term plans by telemarketers. They pitch them as major medical every time. They misrepresent the plans. They misrepresent what a PPO network is. And the poor people that buy them thinking they have health insurance coverage are screwed if they get an expensive chronic illness.

 

[Northeast Agent]

What are the telemarketers saying about PPO networks?

 

[Sherota1]

What are the telemarketers saying about PPO networks?

You will need to mystery shop them to find out. Though about doing this but have not had time. STM's are more catastrophic gap plans. Unsubsidized choose them due to pure need and lack of choice. Low prices and wider networks.

To sell present them as "true major medical health insurance" without disclosing their limitations is just irresponsible. Most seasoned agents sell them with caution and full disclosure of their limitations but the agents that get highlighted in the news are those that bypass these precautions.

Best thing is to know the laws in the states you serve and do right by the client. There is no 100% perfect plan that fits all.

 

[somarco]

Most seasoned agents sell them with caution and full disclosure of their limitations

Do you really believe consumers understand the caveats and will remember them when their claim is denied?

I have dodged a lot of bullets in my career but the one that caused me to take stock in what I would and would not push came early on. I was doing an employee meeting (group insurance) and taking questions. One woman asked if the plan covered maternity. I said it did and moved on to the next question.

Months later I got a call from a man who was very irate because I told his daughter the plan covered maternity. Because I neglected to mention the maternity benefit did not extend to dependent CHILDREN he was pissed when his daughter went to deliver and was told she did not have coverage.

He wanted me to pay but I declined since I was not the father.

You never want to take anything for granted and assume your client fully understands.

I don't sell STM and never will.

 

[Sherota1]

Do you really believe consumers understand the caveats and will remember them when their claim is denied?

"Of course not. But the same applies when full benefit carriers change the rules in the middle of the game. Example "popular carrier denies ER visits considered non emergencies by their definition" even though ER visits are an EHB. As long as carriers can change the rules in the middle of the game what may have been true when the plan was placed in force may not be true when the person goes to use it. They may have been told ER visits were covered only to find out later their (personal ER visit) doesn't qualify. They will remember that they were told that ER visits were covered. This is reality with a carrier in my licensed states" I also get your example above.

You never want to take anything for granted and assume your client fully understands.

Agreed.

I don't sell STM and never will.

Completely understand your position. We all choose what products we will offer and which ones we will avoid. STM's are being used now for unintended purposes. Which I consider to be a misuse of the product and not everyone agrees with that. Many feel that unsubsidized uninsured who can't afford ACA plans only have two choices stay uninsured or pick the best of the imperfect plans that are available.

I can't say I have never sold an STM but only for it's original intended purpose to ones looking for something to cover a small gap in coverage. I get your point but as we know there are ones that offer them on the regular as something that they really are not. Some states are changing the benefits to include more protections but certain limitations will still be there.

Nothing covers 100% even ACA plans. Though we explain that to people most hear what they want to hear. Assuming that the word "Covered Benefit" means it is paid for 100% by the plan when in many cases it is covered but goes toward their deductible.

In my opinion it is the Independent Agent that needs to be the most careful since we know our clients and see them as real people and not a "What's your member number". Larger companies with anonymous agents have money and persuasion on their side. I often find I need to explain the meaning of their questionable commercial claims.

Thanks for your response

Short-term health insurance in Colorado: find affordable coverage

 

[Newby]

What are the telemarketers saying about PPO networks?

They say that PPO means you can go to any doctor and hospital in the country and they can not refuse you. They also say that you will pay the exact same co-pay at all doctors and you do not need to worry about networks.