Frustrating Experience with Cancelled Coverage

[AllenChicago]

I didn't hear anything from Land Of Lincoln Health. This year they are 30% from my new book and I don't know what to expect. Today had a short conversation with a client who has ongoing claim - physical therapy with them. He is happy sins using them.
Any other experience with LLH?

ARus, see the Land of Lincoln thread in the "Illinois" sub-forum. Here's a shortcut for your convenience. Illinois Health Insurance Exchange Forum.

Only a few Illinois agents are members, so don't be disappointed if it's a bit dead over there. Like the overall Insurance Forum, it has 98% more visitors/viewers than members.
ac

 

[ARus]

I hope it is not for real what this navigator told to you. In another forum here I see that someone already received his commissions. BTW, I have non resident license for TX but don't know how to approach my community there. My clients are mainly Bulgarians by origin - 90%. Which company is the best premium-wise for TX?

 

[MaryDallas]

I hope it is not for real what this navigator told to you. In another forum here I see that someone already received his commissions. BTW, I have non resident license for TX but don't know how to approach my community there. My clients are mainly Bulgarians by origin - 90%. Which company is the best premium-wise for TX?

I would suggest going to the Illinois sub-forum and asking that question about Land of Lincoln Health. The navigator's statement was inappropriate was my point. I've seen posts by a lot of brokers here that really like Land of Lincoln Health. You might do a 'search' here and see if you can find those posts and asks those that have an answer to your question.

Texas: I don't go strictly on premium. I ask about doctor/hospital preferences, prescriptions (research) before helping the client decide on their health insurance. Every broker has their own insurance companies they like to write primarily based on their own personal experiences and history with these companies. If an insurance company treats my client good (and pays me) they are on the top of my list. If not, I don't write that company.

I do not like Aetna because I had so much trouble pre-ACA to get a policy through, yet there are some agents/brokers that really like them. Cigna was at the top of my list in 2014; I'm having problems getting paid, so now not so much. Some agents loathe BC/BS, however, so far so good for me.

The directory for some of the carriers are limited in rural areas, however, may be good in the cities. It's all a matter of experience in certain areas. That's why I don't write in other states. I have had my license in every state (with the exception of a few sparsely populated like Utah/Wyoming) in the U.S., however, now just concentrate on Texas. There are plenty of people right here.

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I am getting fed up with how insurance companies are handling enrollments under the ACA. Today we had a pretty devastating case that I have no idea how will turn out. I have client who had baby and we placed the newborn on its own policy about a month after birth, the coverage was set up to start at birth.

We followed the case and made sure the policy was issued and the first premium was drafted and notified the client (it was set up on EFT). This occurred about 10 days after submitting the app, it had to be a paper app so things moved a little slower.

Today, I got a call from the client (good friend of mine) saying that he called in to BCBS with a question and was told that his son no longer had coverage. We found out in the end that the bank draft was returned to his bank 5 days after it occurred so they cancelled the policy due to non-payment. Additionally, the will not reinstate the policy because they claim that there is no 90 day grace period because the policy was never technically put in force to begin with.

We were never notified as an agency that this occurred until just now, the son's policy showed up in our electronic portal as "termed" there was never a lapse notice sent out or any attempt to reach out to us in any way during this time.

They claim they left the client a voicemail about the matter, the client says he never heard it. Now, I know him personally and he is a very attentive individual and good with money, although perhaps not as anal as some people about staying on top of things. From speaking with BlueCross AND his bank, no one knows why the money was returned to his account and neither is claiming responsibility, the bank account had sufficient funds at the time of the draft. BCBS is saying that they didn't do it and refuse to re-instate the coverage, now is son has no coverage, his post birth care was extremely expensive (in the mid six figure range) and the insurance company says we have zero recourse.

Are we already at the "hire an attorney" stage? What are we supposed to do as an agency to make sure this never happens? Beyond making sure the policy is put in force and the first draft occurs, I can't babysit every single policy to make sure it is all working, especially when there is no system in place to notify me of these occurrences until after it is too late.

Was this ON or OFF Exchange? If it is ON Exchange you could use the SEP to enroll. There is a question: "Do you need help with medical bills in the last 90 days (I think it is 90 days)?" Click yes, and see what kind of help they can get. I am assuming it is one-time Medicaid assistance. This is a tough one. I feel for you and the family.

 

[somarco]

Re LOL this information was published. It's old but one has to wonder if they were that far in the hold for the 1st Q of 2014 how it's looking now. Usually the first few quarters of a new block look fine until you learn how to lag the claims

Illinois' only co-op health insurance program lost more than $4 million and enrolled fewer than 2,500 people in its first quarter of operation as it struggled to enter a market dominated by one massive competitor.

Land of Lincoln Health Inc. Co-op had just 2,451 members by March 31, 97 percent of whom bought individual plans. The carrier was established under President Barack Obama's health care reform law and aimed to increase competition in Illinois' individual and group insurance markets.

Meanwhile, the Chicago-based insurer recorded just $1.9 million in premium revenue against $6.1 million in expenses

update

As it starts its second year, enrollment is up significantly. But the company is still in a hole and the clock is ticking on when it must begin repaying up to $160 million in federal loans.

Land of Lincoln's operating loss tripled to $11 million from March to September 2014, a window in which enrollment had for the most part ended. Feb. 15 is the deadline to enroll this year, and so far 30,000 people have chosen a Land of Lincoln plan, a nearly tenfold increase over last year.

 

[tonyisme]

Guess we wont see this reported on THE HILL

 

[somarco]

I guess DC could just loan them money to pay back the loan. That seems to be the way things work these days.

Or pretend it is a student loan or a mortgage and grant forgiveness.

 

[missgingerbgb12]

I would call healthcare.gov.