What to write now in California?

Feb 12, 2008

  1. MHart
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    MHart Super Genius

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    It just seems that it is getting worse month after month in california with the insurance carriers:

    Blue Cross gets fined earlier last year and know is wanting to cancel applications and have doctors tell them about it.

    Blue Shield find for not pay claims

    Pacificare facing a billion dollar fine for not paying claims.

    I don't know about you other agents in CA but leaves my stomach unsettled what is going on out here.

    I have predominatly sold Blue Cross of late but making me reconsider maybe I am reading to much on this.

    Any thoughts or opinions from you california agents on this one?
     
    MHart, Feb 12, 2008
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  2. Dave020
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    Dave020 Super Moderator Moderator

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    Actually, some things have gotten better. ABX seems to have been a wakeup call for Blue Cross, and they have, shall we say, relaxed their individual underwriting up quite a lot in response. I am getting stuff approved level 1 now that would have been rated or possibly declined six months ago.

    Blue Cross got fined for retro recissions on mostly ST health products. Regulators don't like post-claims underwriting so carriers need to do a better job at initial underwriting. Problem is, unless applicant discloses something, it's virtually impossible for the carrier to underwrite for it if they don't know about it.

    This is nothing new - they have paid through a 3rd party for years (now CareTrust used to be CA Physicians Service) and have been notoriously slow in claims paying for years - hence why some providers do not contract with their PPO

    PCare has had a bad rep in CA since the early 90's. Basically they were always so broke they never had money for lunch, much less to pay claims.

    I'll stick with the innovator, best claims payer and most lenient underwriter (Blue Cross). Several years ago Cross set up a computerized claims payment system so that providers got "instant pay" for services. Providers really responded well to typing a service codes and getting the $$ on the spot.
     
    Dave020, Feb 12, 2008
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  3. Crabcake Johnny
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    Crabcake Johnny Guru

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    I think the press in CA seems to have an agenda. Carriers are fined all the time and subject to countless lawsuits. UHC is in a class action for not paying doctors, Assurant's been fined an hammered for yanking policies.

    If it's a carrier then it's lawsuit city:
    Carefirst Bluecross Blueshield Maryland Lawsuit Attorney | Lawyer CareFirst of Maryland Charged With Prematurely Increasing Policyholder Premiums

    That's my local carrier. However, this story never hit the main state news. It's a matter of what the papers choose to publish.

    Anyone sell for Humana?
    Managed Care Challenged in Class Action Lawsuit

    I won't either bothering to go on. Type in the name of any established carrier and it's pages of lawsuit and bad press.

    I don't think the CA carriers are any better or worse. What I think is there's an agenda in CA to go with universal state-wide health care.
     
  4. Dave020
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    Dave020 Super Moderator Moderator

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    John,

    You hit the nail right on the head. LA Times HATES Blue Cross and makes not bones about it. They are behind the initiatives of people like Shiela Kuhl and others to get a single payor system in place.

    This is just a hatchet job over a non-issue.

    I am too busy to go back and see how much press ABX got when it was defeated.
     
    Dave020, Feb 12, 2008
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  5. Soaringagent
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    Soaringagent Guru

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    Blue Cross has been great for a lot my clients in California
     
  6. insuremojo
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    insuremojo Super Genius

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    I've still been writing a lot of ABX but I wont touch the FarmBureau plans anymore. I'm probably gonna start submitting business to either BlueShield or Aetna. HealthNet has been nothing but nightmares of late.
     
  7. Ahnuld
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    Ahnuld Super Genius

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    One of my California agents who is a big producer of health has pretty much winnowed down to Blue Cross, Aetna and occasionally Healthnet. Time (Assurant) is too expensive in California, he won't even touch PacifiCare and while he has a sizable amount of clients in Blue Shield, he is not actively promoting them any longer for the same reasons posted earlier.
     
    Ahnuld, Feb 20, 2008
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  8. JRoot
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    JRoot Guru

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    I've never sold an Aetna plan. Not even appointed by them.

    Alot of agents don't sell PacifiCare in CA. I have been selling PacifiCare to older smokers. They don't rate up for smoking and I like their Rx benefits.
     
    JRoot, Feb 20, 2008
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  9. TXINSURANCE
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    I didn't hear Blue Shield mentioned in this thread? This is still not a viable option for IFP?
     
  10. JRoot
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    JRoot Guru

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    I don't sell much Blue Shield and I spoke with MHart the other day and he doesn't either. IMO, Blue Shield has good plans, just a little more expensive than you can get from Blue Cross and Health Net. I don't know much about their underwriting since I don't do much business them. I'd like to hear someone's insight on Blue Shield CA also.
     
    JRoot, Feb 20, 2008
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