Proposed State Ban on Lifetime Limit

[Winter_123]

Maine - proposed legislation to lift caps. Most likely this will pass sooner or later, and most likely the state will not allow a premium increase. The state has decided that Anthem's parent company is making "too much" as it is so recent preimum requests have been denied regardless of pay-out rations, rising provider costs etc.

This means that other states are expected to subsidize the state.

Refer to previous discussions about rising socialism at the state level, contrary to the assumption that if you can just fend off the feds everthing will be free market. Not so.

Nibble, nibble. Coming to your neighborhood soon.

Bill would halt caps on benefits

 

[somarco]

So what happens when carriers say "enough" and pull out? Wouldn't be the first time.

 

[Winter_123]

So what happens when carriers say "enough" and pull out? Wouldn't be the first time.

As discussed that day is coming soon, except that will only accelerate fed regs to prevent that type of thing. The feds will fix it so that unless you are a purely regional carrier (or some threshold) then you will have to do business in all states if you do business in X number of states. And then the pool becomes interstate and so on.

It's a mess.

 

[CHUMPS FROM OXFORD]

"because we hit the $250,000 lifetime cap soon after his diagnosis"

That's a low cap.

 

[scagnt83]

"because we hit the $250,000 lifetime cap soon after his diagnosis"

That's a low cap.

Who knows the real truth, but I highly doubt that was a lifetime cap on a traditional health policy.
Ive never sold a plan that had a yearly cap on non prescription benefits, but im sure theres one or two out there. Maybe it was a yearly cap... or a limited benefit plan....

Most plans from major carriers here in SC have at least a 2mill max.
And as the agent I always point out the lifetime max.

This wasnt the insurance companies fault, it was either agent or client related.

 

[Winter_123]

Who knows the real truth, but I highly doubt that was a lifetime cap on a traditional health policy.
Ive never sold a plan that had a yearly cap on non prescription benefits, but im sure theres one or two out there. Maybe it was a yearly cap... or a limited benefit plan....

Most plans from major carriers here in SC have at least a 2mill max.
And as the agent I always point out the lifetime max.

This wasnt the insurance companies fault, it was either agent or client related.

Caps will be one less thing to think about before long. They fall into that category where both dems and repubs allegedly agree.

 

[scagnt83]

Caps will be one less thing to think about before long. They fall into that category where both dems and repubs allegedly agree.

When their votes say the same thing that their mouths do after the lobbyist get to them I will believe it.... lol
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It will be interesting to see how many change their tune on some of these alleged agreements after the elections are over

 

[dgoldenz]

"because we hit the $250,000 lifetime cap soon after his diagnosis"

That's a low cap.

Seriously...did they even bother to read the policy, or even the benefit summary? You could blow through $250k in a couple trips to the hospital.

 

[somarco]

FWIW, if a policy comes with a $2M lifetime max the cost to make it $5M or even unlimited is next to nothing.

It is when you have a policy that caps annual benefits at $50k or Rx at $2k and want to lift the limits that you will see premiums jump (or the policy will simply be pulled off the market).

 

[Winter_123]

Seriously...did they even bother to read the policy, or even the benefit summary? You could blow through $250k in a couple trips to the hospital.

It's guaranteed issue state. Most people just get their policies by going to anthem's website or through mega. Either way you are sort of adrift.

I dont see the state going back to agents. Before long caps will be lifted due to either state or fed law and Maine already has guaranteed issue.