GTL Individual Health

mcleanbr

Super Genius
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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.
 
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.
 
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.
 
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.
 
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.
 
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."
 
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...
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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.
 
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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...
 
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