GTL Individual Health

mcleanbr · 10-07-2008, 07:03 PM

I just left a conference call introducing (or maybe re-introducing) an Individual policy for GTL. I have been appointed with them for over a year but their rates were not competitive in Georgia. Their policy looks good because of the removal of limitations on Rehab, Resp., and other Outpatient services. Most major carriers limit these benefits. I was appointed through AHCP and received an email that they were discontinuing their representation of the GTL product. I had heard that the issue was a lack of payment of claims and excessive rate increased. AHCP did not say that these were the issues but somebody connected with them said this. What is your opinion of GTL as an Individual Product?

Thanks for the input.

moonlightandmargaritas · 10-07-2008, 07:07 PM

Quote:

Originally Posted by mcleanbr

Most major carriers limit these benefits.

Can't agree with that statement based on my experience.

Can you cite some examples?

mcleanbr · 10-07-2008, 07:18 PM

I have a BCBS policy that pays for 30 visits per year. Aetna is 24 visits at $25 max., Humana used to be 48 visits but I can't find their latest number. A major accident and you will burn throught this benefit quickly. I remember being trained on the GTL policy were they show several carriers and they all had a visit limitation. On the call that I was on they gave an example of a person needing rehab and being out of pocket several thousands of dollars.

healthagent · 10-07-2008, 07:23 PM

Think GTL's outpatient rehab isn't subject to case management? Think they're going to pay for ongoing therapy like Christopher Reeve? Guess again.

More like a marketing gimmick.

moonlightandmargaritas · 10-07-2008, 07:24 PM

Quote:

Originally Posted by mcleanbr

I have a BCBS policy that pays for 30 visits per year. Aetna is 24 visits at $25 max., Humana used to be 48 visits but I can't find their latest number. A major accident and you will burn throught this benefit quickly. I remember being trained on the GTL policy were they show several carriers and they all had a visit limitation. On the call that I was on they gave an example of a person needing rehab and being out of pocket several thousands of dollars.

OK thanks, I misunderstood.

I thought you were referring to outpatient stuff like MRIs, Cat Scans, etc.

*STIBROKER@AUSTIN.RR.COM* · 10-07-2008, 07:30 PM

GTL Esolution - Page 2

mcleanbr · 10-07-2008, 07:33 PM

They say and it's in the marketing that they pay until $5mil lifetime. I am not sure how they would get out of that. Maybe they pull back something...I don't know as I do not have their new literature. The old policy was very clear that they pay until the lifetime max. Maybe this issue was the problem before. I do not have any GTL customers but would like to hear from people that do and where do they go wrong.

healthagent · 10-07-2008, 07:38 PM

Case review - despite what's written in the policy every carrier reserves the right to review recommended courses of action and decide if:

1) They are going to pay
2) They are going to recommend a different (cheaper) course of action
3) They will simply not pay for the recommended course of action

For example, a doctor might tell a crash victim they need 4 hours a day, every day of outpatient rehab. The carrier might say "ummmm, nope."

moonlightandmargaritas · 10-07-2008, 07:39 PM

Quote:

Originally Posted by mcleanbr

I do not have any GTL customers but would like to hear from people that do and where do they go wrong.

Old time forum members may remember "Brandy the Broker"?

Believe she was from Tejas (?) maybe Dallas/Ft Worth...

She was a part-time insurance broker who was a GTL disciple, I believe. Probably working at Wal*Mart (with one of those stylish blue vests) now...
- - - - - - - - - - - - - - - - - -

Quote:

Originally Posted by healthagent

Case review - despite what's written in the policy every carrier reserves the right to review recommended courses of action and decide if:

1) They are going to pay
2) They are going to recommend a different (cheaper) course of action
3) They will simply not pay for the recommended course of action

For example, a doctor might tell a crash victim they need 4 hours a day, every day of outpatient rehab. The carrier might say "ummmm, nope."

Yes, a good post. This happens a lot in DI policies on claim. A buddy of mine is a DI claim examiner with Met here in Tampa. They are directed to be ruthless.

HomeService · 10-07-2008, 08:03 PM

brandy was here in austin and seemed really nice, but STI was telling her the plan she was selling was not approved here in TX and she kind of disappeared off this board- I do not recall if we ever got the issue resolved : if it was really approved...

somarco · 10-07-2008, 08:10 PM

GTL is a second tier carrier at best. More like a third tier.

They can say anything in a meeting but the rubber meets the road when they actually put it in writing.

I don't suppose these marketing Einstein's provided you with a link to a brochure on this new & improved product.

You sound like someone who is drinking the KoolAid.

GTL good, all others bad.

The major carriers in GA are Aetna, GR, Humana. Add in BX (just because people will expect to see a Blue quote and they are currently giving away the store in underwriting) and KP since you are in their marketing zone.

If you are a real glutton for punishment, showcase Coventry but don't count on getting anything thru underwriting.

All of those are brand name carriers. Why do you feel a need to offer GTL?

I have similar comments for Antex and Imerica.

moonlightandmargaritas · 10-07-2008, 08:15 PM

Quote:

Originally Posted by somarco

I have similar comments for Antex and Imerica.

No, no - did you miss the thread?

Tom from "Insura-double-wide" (outside of Valdosta?) said that ANTEX was the nuts.

somarco · 10-07-2008, 09:04 PM

Quote:

did you miss the thread?

Senior moment . . .

myinsurebiz · 10-07-2008, 09:06 PM

Quote:

Originally Posted by moonlightandmargaritas

No, no - did you miss the thread?

Tom from "Insura-double-wide" (outside of Valdosta?) said that ANTEX was the nuts.

Go Red Soxs!

Hey sunlight - try and quote people correctly pal.

GTL - like GR and others utilize the exact same PPO's - PHCS and others.

2nd tier / 3rd tier - who cares as long as the client gets what they pay for and the claims are paid ? ? ?

GTL has some decent plans that are competitive in certain States . . .

Sell it you can I always say . . .

Thank goodness I leave health to the old hens . . .

Tom

somarco · 10-07-2008, 09:11 PM

Quote:

GTL - like GR and others utilize the exact same PPO's - PHCS and others.

Actually, no.

GR uses the UHC network.

Yeah, I know. Surprised the hell out of me too.

*STIBROKER@AUSTIN.RR.COM* · 10-07-2008, 10:18 PM

thanks for that .....I was looking for that thread....

GTL??

Quote:

Originally Posted by HomeService

brandy was here in austin and seemed really nice, but STI was telling her the plan she was selling was not approved here in TX and she kind of disappeared off this board- I do not recall if we ever got the issue resolved : if it was really approved...