Debunking the Myths of the Mini-Med Plan

TXINSURANCE · 08-22-2008, 09:21 AM

Add to Rob's post; the State of residence (ie: Georgia) does not have a GI or high risk pool.
Client 57yo male, has great current health (8+ years). Only issue is he currently has acid reflux; In 2000, client had open heart surgery, dual bypass. He makes 6 figure income, drives nice, lives nice, and self insures. He knows that one incident can empty their savings. He has contacted me seeking someone to cover him. Any ideas?

This is a very high risk client.

Every state has a safety net program.

Since GA does not have a risk pool, you have HIPAA plans if HIPAA eligible, I am sure about 1 man groups in GA I do not write group in GA.

Every state has a safety net program, the trick is the consumer must be pro active and play by the rules. Most do not.

Some can not afford the coverage, I understand that 100% - but most can they just do not want to lower their lifestyle of dining out, shopping, cell phone, cable and car payments to buy health insurance.

robliano · 08-22-2008, 02:58 PM

I'd like to add one more thing:

If someone cannot get major medical, cannot get medicaid, etc etc. and possibly some unlicensed jackass will try to mislead a consumer into a bogus mini med just to get an app fee, then I do not feel bad or unethical about properly presenting and offering a reputable alternative to them, and then let the consumer decide.

retread · 08-22-2008, 05:17 PM

Originally Posted by agent4sail

Add to Rob's post; the State of residence (ie: Georgia) does not have a GI or high risk pool.
Client 57yo male, has great current health (8+ years). Only issue is he currently has acid reflux; In 2000, client had open heart surgery, dual bypass. He makes 6 figure income, drives nice, lives nice, and self insures. He knows that one incident can empty their savings. He has contacted me seeking someone to cover him. Any ideas?

You're being baited for this one. I would steer clear... "He knows that one incident can empty their savings." is a red flag. He needs INSURANCE, not a health benefit plan. Mini-Meds are a setup for the unsuspecting to get financiallly creamed by a catastrophic medical issue. It works fine for everyday health issues, but when the big one comes, you are toast!

Make absolutely sure he knows this risk, and have him attest to this fact IN WRITING before you sign him up on one.

Mini-Meds have their place, but MUST be sold responsibly.

ijerome · 08-22-2008, 07:43 PM

Oh my....Please send me those you won't enroll in a mini-med because of financial or health conditions. The way I sell is to make sure several times that the prospect fully understands what he is getting. I also, read the fine print and take him via webinar to the insurance company underwriting the plan. It must have a real company, listed with Best, behind it. And in some cases I will call the PPO doctor or hospital to make sure they accept the plan and do repricing. Not a lot of work to make ongoing commissions.
Now, if major medical would stay on the books, oops that's another story. All those insurance policies that lapse in 2d & 3rd year. What good does that do the client?

What about some of your clients in PacificCare and Blue Cross in Ca. Companies doing right bytheir customers, and facing billion dollar law suites. Or Mega..and many others in major medical insurance? Still in business??? why ???

It seems like so many debunking mini-meds are doing perfect business with perfect companies and perfectly happy clients,
That is until the premiums increase 20-30%. and then one takes great pride switching carriers, if the client is still healthy. So it goes in an unperfect business waiting to see how the new congress and pres. Can make it better. Happy dreaming.

robliano · 08-22-2008, 07:45 PM

I must say I'm looking forward to the responses to this.

Originally Posted by ijerome

Oh my....Please send me those you won't enroll in a mini-med because of financial or health conditions. The way I sell is to make sure several times that the prospect fully understands what he is getting. I also, read the fine print and take him via webinar to the insurance company underwriting the plan. It must have a real company, listed with Best, behind it. And in some cases I will call the PPO doctor or hospital to make sure they accept the plan and do repricing. Not a lot of work to make ongoing commissions.
Now, if major medical would stay on the books, oops that's another story. All those insurance policies that lapse in 2d & 3rd year. What good does that do the client?

What about some of your clients in PacificCare and Blue Cross in Ca. Companies doing right bytheir customers, and facing billion dollar law suites. Or Mega..and many others in major medical insurance? Still in business??? why ???

It seems like so many debunking mini-meds are doing perfect business with perfect companies and perfectly happy clients,
That is until the premiums increase 20-30%. and then one takes great pride switching carriers, if the client is still healthy. So it goes in an unperfect business waiting to see how the new congress and pres. Can make it better. Happy dreaming.

retread · 08-23-2008, 01:14 PM

I think it is a good post!

SportsNut · 08-25-2008, 08:06 AM

Originally Posted by moonlightandmargaritas

Here in Florida, one person group for legitimate businesses is available on a GI basis during the open enrollment month of August each year. Not cheap, but available.

Sounds like an HMO with open season offering. Does one have to be a legitimate business in order to enter the open enrollement, if in fact it is an HMO...?

SportsNut · 08-25-2008, 08:11 AM

Originally Posted by TXINSURANCE

Every state has a safety net program.

.....

Every state has a safety net program, the trick is the consumer must be pro active and play by the rules. Most do not.

So sans the high risk pool, and in a state that does not offer GI for a grp of one, what does a small business person do if they have pre-x uninsurable condition(s)...? Tell me what rules they mst play by in order to obtain maj med ins...?

moonlightandmargaritas · 08-25-2008, 08:32 AM

Originally Posted by SportsNut

Sounds like an HMO with open season offering. Does one have to be a legitimate business in order to enter the open enrollement, if in fact it is an HMO...?

No, it's not an HMO.

Each company that sells group health insurance in Florida has to offer guaranteed issue 1-person group during the month of August each year.

somarco · 08-25-2008, 08:48 AM

in a state that does not offer GI for a grp of one, what does a small business person do if they have pre-x uninsurable condition(s)...? Tell me what rules they mst play by in order to obtain maj med ins...?

The rules vary by state, but all states have provisions for uninsurables.

TXINSURANCE · 08-25-2008, 09:30 AM

The rules vary by state, but all states have provisions for uninsurables.

Correct.

The issue is most consumers do not play along correctly, do their homework and research. I hear consumers time and time again putting their own emotions ahead of logic and common sense.

The real challenge is states without risk pools or poorly run risk pools. States with well run pools - this issue is much easier to manage.