What's Going On?

Dec 11, 2007

  1. somarco
    Offline

    somarco GA Medicare Expert

    Posts:
    29,778
    Likes Received:
    3,737
    State:
    Georgia
    What's going on with Time?

    In the last 2 weeks I have replaced 2 Time policies (both HSA) due to

    1)rate increases of 25%+

    2) denials of claims on px conditions.

    In both cases PH was on maintenance meds for 8+ yrs and these were revealed on the app. One was taking hypothyroid meds, the other meds for HTN.

    Client tells me Time is challenging the claim as PX and refusing to allow credit towards the deductible.

    I hardly use Time so this is not a problem for me, but wondering if others have the same experience.
     
    somarco, Dec 11, 2007
    #1
  2. Crabcake Johnny
    Offline

    Crabcake Johnny Guru

    Posts:
    14,811
    Likes Received:
    19
    State:
    South Carolina
    I think Time's plan is to start denying all pre-ex conditions, even if stated on the app. This way clients will get real pissed and cancel. And when all of their clients cancel they won't have any claims to pay and the stock will go through the ceiling.
     
  3. moonlightandmargaritas
    Offline

    moonlightandmargaritas Guru

    Posts:
    9,748
    Likes Received:
    39
    State:
    Florida
    Can't speak to the pre-x claim denial scenario, but I've been replacing them (even my own book) for the last couple of years due to 25% rate increases. I don't have much of it left. Filed here (FL) as an association plan so anything goes.

    My theory from their marketing is that they want to do solely short-term. They recently sent out emails comparing their STM to Bx FL, and HPA's STM.

    Talk about pre-x claim problems!
     
  4. Crabcake Johnny
    Offline

    Crabcake Johnny Guru

    Posts:
    14,811
    Likes Received:
    19
    State:
    South Carolina
    Guess I'm lucky here in MD - 22% this latest round and 10% healthy discount which well over 90% of my clients get which is 12% net increase making them the lowest increase in my state. No healthy discount available in FL - kinda sucks. But nothing compares to the ass-kicking Aetna gave my clients.
     
  5. somarco
    Offline

    somarco GA Medicare Expert

    Posts:
    29,778
    Likes Received:
    3,737
    State:
    Georgia
    I have no direct knowledge on the PX issue, just what these folks tell me. Both bought thru their SF agent. Both told me their SF agent said to call me (and I don't even know the guy).

    They have already taken heat in at least one state (can't recall which) on the PX denials. I just assumed it was on STM which won't pay for anything except accidents.

    Carriers can do some really stupid things. Claim denials, rescissions, 25 - 40% (and higher) rate increases, off anniversary increases.

    Is it any wonder folks are screaming?
     
    somarco, Dec 11, 2007
    #5
  6. arnguy
    Offline

    arnguy Guru

    Posts:
    7,786
    Likes Received:
    17
    State:
    Pennsylvania
    Is this information applicable to Assurant,ie., are they interchangeable?
     
    arnguy, Dec 11, 2007
    #6
  7. somarco
    Offline

    somarco GA Medicare Expert

    Posts:
    29,778
    Likes Received:
    3,737
    State:
    Georgia
    Assurant owns Time. Time is the issuing carrier in most (if not all) states.
     
    somarco, Dec 11, 2007
    #7
  8. salpro22
    Offline

    salpro22 Guru

    Posts:
    1,971
    Likes Received:
    30
    State:
    Texas
    Were you able to switch the people to a different plan? I find it interesting that your competition would refer these people to you....especially considering the fact that you do not know him.

    Correct me if I'm wrong, with the exception of insurance fraud and the guidelines of an insurance carrier, denying claims just to do so is kind of like playing russian roulette if you ask me.
     
    salpro22, Dec 11, 2007
    #8
  9. somarco
    Offline

    somarco GA Medicare Expert

    Posts:
    29,778
    Likes Received:
    3,737
    State:
    Georgia
    Yes, I did place them with a different carrier.

    Because of some community work I do, I get a fair number of referrals from various sources, including other agents. SF is not a competitor since I don't write P&C and their only health outlet is Time.

    Nothing wrong with denying extra-contractual claims, but some carriers go to extremes to deny a claim. That is just stupid.
     
    somarco, Dec 12, 2007
    #9
  10. moonlightandmargaritas
    Offline

    moonlightandmargaritas Guru

    Posts:
    9,748
    Likes Received:
    39
    State:
    Florida
    Last week I received a notice from Time/Fortis/Assurant/Time that my client's premium is goin' up as of 2/1/08.

    Shop it and find that GR premium is 38% lower, with a lower deductible and out of pocket limit! Fortunately a young couple with no pre-x issues. Client naturally says...do it. Issued yesterday (about 24 hrs.). Emailed client this morning that it was approved, with instructions how to cancel Time.

    He just called me.

    They transferred him to the "retention unit", where he was told for the premium he was paying, I must be giving him "substandard" coverage.

    I'll tell ya, I'm done with these guys. I'd call the RSM, but he's as useless as tits on a bull. These guys have really gone downhill in the last couple of years...and they used to be my main carrier!
     
Loading...