Yet Another Humana Question

[AndreaSti]

Since we have all been talking about Humana and their issues lately I thought I would post another one. This is the opposite of what normally happens which makes me really suspicious so I need some opinions on this one. We have a long time client (over 10 years) who is currently insured but want to lower their premium and have moved to Humana:

1 adult in her 30s, 2 children. Policy issued without modifications, even though they disclosed their 2 year old has been advised to have tonsils removed, haven't done it yet. They purchase a $5k deductible. Parents get to talking, and decide since they have this pending surgery, why not lower the deductible, get the surgery done, then make the deductible higher afterwards (argh). Agent calls the client, says you should really have this done under your current plan, and are you sure you disclosed this to the underwriter? They insist they told Humana in a phone interview that the surgery is pending. We have written proof the policy is issued standard, no rate ups on the kid.

Anyway, now they say they called Humana back and have lowered the deductible. I got the confirming email today, with new plan and premium issued without modification. Am I crazy, or are tonsillectomies (sp?) gotten so cheap they don't care, or what? Again, I am suspicious of this one, don't want Humana coming back later and denying coverage. We have a copy of the app, and they answered "yes" to the ear, nose throat question. We don't seem to be able to see the details on a Humana app anymore but it seems to me the client has indeed disclosed the surgery.

Am I missing something here, or just paranoid?

 

[houcoogster]

They can use some of the money they stole from Somarco to pay the bill.
I would let it go, sounds like everything is in order.

 

[AndreaSti]

They can use some of the money they stole from Somarco to pay the bill.
I would let it go, sounds like everything is in order.

Yes it is just that they have been our client forever and I don't want anything to go wrong! Don't trust em, they do reviews on EVERYONE first year into the policy.

 

[somarco]

How did they answer question 11 on the app?

Humana has started sanitizing apps so you can no longer see the enhanced answers to yes questions. That really bums me out.

Not funny houcoogster . . .

 

[taterpeeler]

Did you personaly take the app? If not and they did it all on their on then its not your problem, move on.

I dont think the agents job is to interrogate the new client in an attempt to assertain if the client is lying when the client filled out the app on their on

 

[AndreaSti]

How did they answer question 11 on the app?

Humana has started sanitizing apps so you can no longer see the enhanced answers to yes questions. That really bums me out.

Not funny houcoogster . . .

They answered "yes" to the question, and claimed they talked with the underwriter about it during the phone interview.
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Did you personaly take the app? If not and they did it all on their on then its not your problem, move on.

I dont think the agents job is to interrogate the new client in an attempt to assertain if the client is lying when the client filled out the app on their on

I agree not to interrogate but they are not a new client, they have been with us for over 10 years and have referred family etc so I don't want them to have any issues with this.
- - - - - - - - - - - - - - - - - -

Did you personaly take the app? If not and they did it all on their on then its not your problem, move on.

I dont think the agents job is to interrogate the new client in an attempt to assertain if the client is lying when the client filled out the app on their on

PS: they applied online through our link. At home, not in our office.
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How did they answer question 11 on the app?

Humana has started sanitizing apps so you can no longer see the enhanced answers to yes questions. That really bums me out.

Not funny houcoogster . . .

Sanitizing apps is one step toward shutting out the agent. But conversly yesterday one of their reps told one of our clients not to call them again with any questions, call their agent. Said the rep was rude. Not sure what the issue is over at H1.

 

[somarco]

Humana is not the only one who passes off policyholders to agents, I have had the same thing occur with GR and Coventry, and I don't do anything with Coventry, haven't for years.

This "hot potato" game will continue, thanks to Obamacrap and MLR , because no one is paid enough to properly render service to clients.

 

[AndreaSti]

Humana is not the only one who passes off policyholders to agents, I have had the same thing occur with GR and Coventry, and I don't do anything with Coventry, haven't for years.

Why don't you work with Coventry, if you don't mind me asking?

 

[somarco]

Coventry sucks, that is why.

When I did try to work with them I had more service complaints than any other company and I had fewer clients with them compared to the rest.

Their underwriting is schizophrenic. Billing a disaster. And they are staffed by idiots.

Other than that, I have no complaints about Coventry.

 

[AndreaSti]

Coventry sucks, that is why.

When I did try to work with them I had more service complaints than any other company and I had fewer clients with them compared to the rest.

Their underwriting is schizophrenic. Billing a disaster. And they are staffed by idiots.

Other than that, I have no complaints about Coventry.

Some agents write a lot with them, but I think they are losing agents every day who are tired of dealing with their BS. Rate increases have been (this I predicted) horrendous. Also, heard their Georgia MLR was at 54 at the start of all this Obamacrap and that makes me nervous. We don't write much with them anymore, and we usually present them with other carriers to our clients who make the final decision. Many are going with Humana which is why I started this thread. The clients mentioned were with Coventry BTW before moving to Humana.