Forced Change from Non-Compliant to Compliant Plan..Need Advice.

[AllenChicago]

In late August I wrote four $10K deductible health insurance policies that had a limit on the number of Doctor Visits Co-pays and on outpatient testing. They went into effect on October 1st.

Yesterday, the company sent a letter to these clients informing them that their policies were "non-compliant" with the Affordable Care Act and that they they were being retroactively changed to a compliant plan within the company's overall portfolio. That's fine, but the premium increases for the compliant plans range from 31% to 44%.

The company sent me an e-mail last night advising me to call these clients and give them a "heads-up". I did call them this morning and you can imagine the reactions..


Anyway, what would you do in this situation??? Several policies at our agency fell into this snare. Our agency owner is working with the health ins. company to avoid having these clients pay any more money for their new plan, because the company should not have approved these policies in the first place. Hopefully, this will be resolved quickly in that manner. I'd hate to see the insurance commissioner, or some attorney get involved on behalf of these clients.

-A.C.

 

[Crabcake Johnny]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

This is pure 100% steaming BS. They want them off the books - period. Nationally, to become complaint with health care reform, the average premium went up 8%.

 

[AllenChicago]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

The policy that these families bought had to be discontinued on October 1st, due to it not being compliant. The health insurance company approved and issued the policies when they should not have been issued. The policies that these clients were converted to have lower deductibles and no restrictions on anything. Actually, they're much better plans, that sell for a lot more. But, the clients should not have to pay for them, because these richer-benefit plans are not what they applied for, or approved for.
-AC

 

[Crabcake Johnny]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

Those plans shouldn't have even been offered post 9/23. I'd tell all of 'em to file DOI complaints.

We can't say that raising a stink never works. Remember Anthem in CA with their proposted 39% hike? Everyone went nuts and all of sudden it was "math error."

Anthem's trying to ram up up their a** in CT. The commissioner who initially approved the hike stepped down, now there's a hearing on it and a coalition of 6,000 doctors are prepared to sue.

 

[Dave020]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

Confusion on this lies strictly with HHS. The carriers were originally told to comply 9/23 or at the portolio renewal date (mostly 1/1/11). Most carriers planned along this line to changeover 1/1/11.

HHS recently clarified this to the carriers (I was told by Anthem) and told them the change was supposed to be on 9/23, not at portfolio renewal date.

So, carriers were selling plans 10/1 that were compliant AT THAT TIME before HHS jumped in and changed the rules (or re-interpreted them).

Change you can believe in!!

 

[AllenChicago]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

Confusion on this lies strictly with HHS. The carriers were originally told to comply 9/23 or at the portolio renewal date (mostly 1/1/11). Most carriers planned along this line to changeover 1/1/11.

HHS recently clarified this to the carriers (I was told by Anthem) and told them the change was supposed to be on 9/23, not at portfolio renewal date.

So, carriers were selling plans 10/1 that were compliant AT THAT TIME before HHS jumped in and changed the rules (or re-interpreted them).

Change you can believe in!!

Dave, your interpretation is exactly what this particular insurer told me. They say that that in hindsight, they should have quit selling the non-compliant plans in August, when HHS first indicated that there "might" be date revisions forthcoming. HHS minions did send out the date revision final guidance...at 4pm on the Friday before the long Labor Day weekend. Suddenly, the four applications I had in underwriting on that date were for "non-compliant" health policies. By the time word trickled down to underwriting, all four had been approved, issued, mailed.
-AC

 

[somarco]

Re: Forced Change from Non-Compliant to Compliant Plan..Need Advi

Care to name the carrier?