Georgia Obamacare Combatants

[kgmom219]

Why does that scare you? What do you suggest for a couple with 2 kids and new rates going to 2000 a month? They don't have the increase. They could go medi share or they could go STM. When clients ask for their options do you not show STM? The last person I talked with at UHC said they couldn't make a claim against HPB, or other those meds by law. Just telling you what they said.
I fail to see the problem with pre ex if the client says no issue or say they haven't been to a doc in 5 years.

If they haven't been to a doc in 5 years, that means they haven't had an RX in 4 years. That's fine. If they have taken HBP meds, they are going to apply pre ex.

And in TX, there is 12 month pre ex limit.

I would rather they get a "real" plan with the crappy Medicaid network. Pay cash for the docs they want and RXs are covered when written by non-net docs. Catastrophic events covered and catastrophic diagnosis are fine at the hospitals.

But I also get that I'm in DFW with that option.

I'm also moving my current PPO people to group. Rates are holding from 2016 and they are happy.

I would prefer a Fixed Indemnity plans over STM. Its upfront on what is and isn't covered.. STM plans offer a false sense of security.

 

[somarco]

Ned, STM carriers are notorious for post-issue underwriting on any claim of consequence. Assurant had a real bad rep for post-issue underwriting, denying claims and retroactively canceling coverage.

The old plans had a 5 yr lookback on p-x. Not sure about the new ones.

As for what I do if someone can't afford Obamascrew?

Not my circus. Not my monkeys.

I figured out a long time ago I can't fix everyone's problems. I work on the ones I can and send the rest on their way.

More than once I have had people call me up and tell me that another agent found them a plan when I could not. And in many of those situations I had some of them call even later to say their claim was denied, coverage cancelled, etc and what could I do.

Same answer as before.

Not a damn thing.

 

[bluemarlin08]

I understand. My example of a couple and 2 kids staring at 2000 per month premium, just don't have the additional cash flow. Should they consider STM if they understand the pre ex conditions and penalty, the reality of a large claim is around 5%, add in an 18,000 cash flow swing. Seems if one is still lingering in this market should be an option? Full disclosure, it pays 25% fyc.

 

[somarco]

Ned, everyone has to follow their conviction. I have always wanted to help people anyway I can but self preservation trumps my desire to help. I am all for making money but to me, the personal risk overrides my desire to recommend a product I would not buy.

That being said, I am glad I had access to employer group health through my wife in the past.

 

[bluemarlin08]

If they haven't been to a doc in 5 years, that means they haven't had an RX in 4 years. That's fine. If they have taken HBP meds, they are going to apply pre ex.

And in TX, there is 12 month pre ex limit.

I would rather they get a "real" plan with the crappy Medicaid network. Pay cash for the docs they want and RXs are covered when written by non-net docs. Catastrophic events covered and catastrophic diagnosis are fine at the hospitals.

But I also get that I'm in DFW with that option.

I'm also moving my current PPO people to group. Rates are holding from 2016 and they are happy.

I would prefer a Fixed Indemnity plans over STM. Its upfront on what is and isn't covered.. STM plans offer a false sense of security.

How are you getting them on group plans?

 

[kgmom219]

How are you getting them on group plans?

It requires a Wage and Tax (each state calls it something different) and a non-family member. (Which may or may not be your sister, with her married name, who lives at a different address).

Its working, clients are happy. The PPO rates aren't any higher than the $6450 Humana plan from this year, they get a true PPO and are off the Obamacare trainwreck.

Oh...and we get paid, too.

PM me if you want to discuss further.

 

[TN_agent]

Yeah, our agency is seeing a ton of interest in group and we are promoting heavily if legally possible. With BCBSTN exiting bigger cities, a ton of interest. Some are requesting start dates immediately once we explain they don't have to wait for January.

Group rates in TN are now in many cases cheaper than the individual rates with better networks, deductibles, more choices, etc. A lot more work on the front end, but it tends to stay around for a while.

Now, off this forum and back to calling my Medicare people....

 

[kgmom219]

Yeah, our agency is seeing a ton of interest in group and we are promoting heavily if legally possible. With BCBSTN exiting bigger cities, a ton of interest. Some are requesting start dates immediately once we explain they don't have to wait for January.

Group rates in TN are now in many cases cheaper than the individual rates with better networks, deductibles, more choices, etc. A lot more work on the front end, but it tends to stay around for a while.

Now, off this forum and back to calling my Medicare people....

...............................Exactly

 

[Puddleglum15]

Georgia will be Ambetter, BCBSGA, and Kaiser.

 

[cornelius322]

I'm seeing at shop.bcbsga.com you can see already 2017 on and off exchange plans and that includes off-exchange "OpenAccess POS".