Mega Strikes Again NASE/UGA/HEALTHMARKETS

MAGE life & health is a scam

I used to be affiliated with these con artists. I was one of their top agents in northern California. Until I found out that the coverage that they offer is a scam. I am still in the insurance business and work with every major company in the state of California. I can confidently say that plan offered by the NASE (National Association for the Self-Employed) are the absolutely the worst coverage you can get for your money. Anyone who says anything remotely good about this organization is obviously affiliated with them. At one time I would defend them with sweat and blood, until I found out it is a scam. Agents that represent this outfit are usually new to insurance industry so they do not know anything about any other insurance products. Organization itself consistently “Brainwashes” agents that they have the best product on the market. The system setup similar to Multi Level Marketing Organization where there are multiple levels of managers, that weekly conducts agent meeting to do agent “brainwashing”. That is the only way to keep agent to be part of that outfit. Agents that find out that it is a scam usually leave and try to take their entire clients away from the con coverage. It is a biggest battle between NASE and agent that leave. To this day I still deal with customer services issues and claims that were not covered by NASE. Some agent that I used to work with at NASE when they left, they had to disconnect their cell phones and some had to leave their town because of all the customer service issues. Some left because of selling that plan to their close friend and relatives who now got stuck with thousand of dollars of unpaid claims. Clients that I was not able to get of NASE coverage because of their medical status (pre existing conditions), I keep getting calls from them with all the claim that do not get paid.
Now I represent every major carrier in the state of California and IÂ’ve NEVER had insurance company not cover a claim. From selling that ****ty NASE coverage I have collected close to one hundred, yes 100!!!, bills that were not covered by NASE. All I have to say is that if you are agent representing NASE and you know that what you are selling is a bad plan and you are keep convincing people to get it, you are CRIMINAL and if you got my hand on you I would break your neck. Ripping off families and hard working self-employed people who some barely making their ends meet. NASE and MEGA Life & Health Insurance Company must go out of business.
 
http://www.boston.com/business/glob...cost_insurer_leaves_bills_and_a_bitter_taste/

Low-cost insurer leaves bills and a bitter taste
Critics cite confusion and policy limitations

By Christopher Rowland, Globe Staff | October 31, 2006

ATTLEBORO -- Erin Chartier fumes every time she receives mail with her health insurance company's slogan: "Keeping the Promise of Affordable Coverage."

"It's affordable because they don't cover anything," she said. "It makes me so mad."

Chartier, 22, spends her days in a small apartment with her 2 -month-old daughter, Karli, who was born five weeks premature. Chartier and her husband, Earl, face about $50,000 in medical bills they thought insurance would pay.

They are insured by Mid-West National Life Insurance Co. of Tennessee , whose low-cost health insurance plans have generated similar complaints from other consumers. Mid-West National Life and a sister corporation, MEGA Life and Health Insurance Co. , are subsidiaries of HealthMarkets , a for-profit national company based in Texas.

The companies provide health insurance to only about 30,000 Massachusetts residents, but that number might grow. Some state officials say MEGA Life and other insurers that offer low-cost policies to small businesses could play a role in the state's attempt to expand healthcare coverage to all residents. The reform law requires all Massachusetts residents to purchase insurance.

Last week, MEGA Life was sued by Attorney General Thomas F. Reilly's office, which alleges the company used deceptive marketing, failed to cover mandated benefits, and improperly denied patient claims. Also, MEGA Life and Mid-West are the subject of a multi state examination by insurance commissioners, as well as the focus of a separate examination by the Massachusetts Division of Insurance .

The policies -- mostly purchased by people who work for small businesses -- feature premiums as low as $300 for a family, less for individuals. But they also contain a confusing mix of deductibles, co payments, and coverage maximums on physician visits, hospital stays, and tests.

<font>Consumers contacted by the Globe said agents aggressively promoted the policies' $1 million lifetime benefit, with a single deductible of $1,000 for hospital stays. But limitations make the coverage illusory, say critics.</font>

"These Swiss-cheese plans attract people with lower premiums, but they have lousy coverage," said Stephen D'Amato, a public interest lawyer and former Massachusetts state insurance regulator. "These kinds of plans should never hit the market."[/b]</font>

The Chartiers' limited benefit plan cost Earl Chartier's employer, a small engineering firm, $336.06 a month.


<font>But coverage for hospital room and board is capped at $400 a day -- Erin Chartier's expenses were five times higher, about $2,000, leaving the Chartiers responsible for $1,600.</font>

Physician visits while in the hospital are limited to one per day, at $100, and office visits are covered up to $50. Miscellaneous hospital inpatient charges are covered at 80 percent, but only up to $12,000.

Such restrictions are necessary to keep premiums low enough to help people who lack access to the more comprehensive plans many large companies offer, said HealthMarkets chief executive William J. Gedwed in a written response to the Globe.

"Many insurers simply choose to ignore this underserved group of people," he said.

HealthMarkets says it is trying to improve service by training agents to give customers a more detailed disclosure of the coverage limits. Yet some consumers said<font> MEGA Life and Mid-West agents they spoke with did not fully disclose the drawbacks to their policies. And the fine print, they said, was difficult to understand.

"The way that it's worded, a lay person could never figure out," said Linda Gilardi of Pittsfield, whose husband's quadruple bypass surgery in 2005 was only partially covered by MEGA Life. The family ended up with a bill for about $57,000, she said.

Gilardi said she and her husband asked a MEGA Life agent how their premium could be so low compared to large HMO plans, and the agent told them the self-employed and those who work for small companies "don't call in sick, they work, and they don't abuse the health plan, and we are able to pass the savings on to you."
</font>


Mid-West's and MEGA Life's products are examples of health insurance products dubbed by proponents as "consumer driven" or "consumer guided." The theory is that patients who are forced to pay a greater share of their own medical expenses will have an incentive to shop for better prices, driving down overall costs.

Critics say the plans make more profits for insurance companies and allow employers to shift costs to workers.

"It's troubling to me that we would do anything to encourage these types of companies to do business in Massachusetts without substantially more state oversight," said Laurie Martinelli, executive director of Health Law Advocates, which helps consumers cope with medical bills and file complaints about their bills and coverage.

"We have heard from more than a dozen consumers who have regretted buying these plans because so little is covered," she said.

Erin Chartier said the Mid-West agent who explained the healthcare plan last year did not disclose the coverage limitations. The family's medical bills have come from Brigham and Women's Hospital, its physician organization, and Sturdy Memorial Hospital in Attleboro.

"We try to pay on the big bills, $50 a month. It's hard to keep track of them all," she said.

After the Globe contacted HealthMarkets earlier this month to ask about the Chartiers , the company reviewed the case and contacted Erin Chartier last week. Chartier said the company offered to pay 80 percent of what the couple owes.

"I was pretty upset, because we had already spoken with the company about the misrepresentation of benefits, and they didn't seem to care what happened to us," she said in an e-mail. "Suddenly, they're on the verge of getting really bad press and now they want to talk?"

Mid-West said the agent who sold the policy to Earl Chartier's employer did disclose benefit limitations at a meeting Chartier attended, and also left behind brochures. But a telephone service representative did not fully inform the couple of their coverage limitations, said HealthMarkets chief executive Gedwed.

"This policy was never presented as major medical or a comprehensive policy," he said. "In this case, we did not accomplish our mission. We believe that doing the right thing is good business."
 
Sounds like the Mega training I went through.

Talking points:
- Self employed people do not abuse their policy.
- You are in a pool of 600,000 people where the risk is spread out more.
- We have strict underwriting to keep claims under control (the take away)
- Never say major medical
- Do not offer info (most of us were so new that we did not even know what to say or what loop holes were there)
- The $400 hospital per day benefit was based on our lower rates, rather then the higher regular rates
- We limit your Dr visits to help keep costs down

What I say to people about individual health:

If I was a mechanic and I said I can maybe fix your car for $200, no refund, or I can fix it for sure for $260, what would you do? Gamble on the $200 or do it right for $260? That is what you are doing with your health insurance. Maybe I will be covered for $200 (Mega) or I know I will be covered for $260 (major med plan).

Those are just numbers I pulled out of the air. Usually, I can beat Mega rates using an HSA.
 
MEGA Life & Health bills that were not coverd

mega_life_and_health.gif


Here is a copy of one of bills that I received from one of my old MEGA Life and Health Clients. That is unfortunate that I could not switch some people fast enough to a better coverage. This is a young family that is no way is going to be able to afford that bill and there is little they can do, but to pay it overtime.

This is one of dozens of bills that I received from my past clients that MEGA did not pay. I wish I had time to scan them all and post them. I know in some other post, some NASE agent mentioned something about the proof that MEGA does not pay. So here it is you can see it by looking at the network name (CCN Network). I am also going to see if I can post a copy of the bill from MEGA when they will get it.

I remember being told that it is better to have some coverage than not at all at NASE Trainings. The fact is, it is better not to have any coverage than to have NASE plans. Just save the money that you were going to pay in premiums and you are going top be ahead.

Bill was for delivery of a baby. The coverage that they had, had maturity rider added. This is what they were responsible to pay after MEGA paid and after the contracted rate discounts. Enjoy. More to come.

If you are NASE agent don't even waste your time replying because I just don't give a F**K about your opinion.
 
Re: MEGA Life & Health bills that were not coverd

thebeacon said:
Here is a copy of one of bills that I received from one of my old MEGA Life and Health Clients.

It's a wonder they didn't sue you. And that's nothing against you, because I sold one plan with a 3K maternity benefit myself and I hope I never see those folks again, as it was many years ago.

Sorry, but I have to say it one more time: It's a complete joke that I can lose my license for selling life insurance as an investment while these filthy bastards (referring to seasoned NASE agents and trainers) are running around doing this stuff. The DOI should never approve this kind of maternity coverage, IMO, and should put people that know they're selling inadequate coverage in prison.

UICI is a stock company and I hope it goes the way of Enron--with the top dogs behind bars and the company out of business.

To any NASE agent that attempts to defend them--you're the lowest of rotten sh*t. If you find this out for the first time, do what any agent with integrity has done and cancel your book of appointments and resign immediately. I began having doubts shortly after I started and it didn't take too long till I found out.
 
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