A Special Enrollment Period Will Allow a Consumer to Enroll

[AllenChicago]

I just noticed that the "Death in Family" SEP has been refined to say "Death of Family Member on the Plan".

Last year (2015) I did 2 SEP enrollments due to a family member passing away. In both cases, they were not on the plan. One applicant didn't even have health insurance, but because her Aunt died, she was SEP eligible.

Knowing our government, I'm sure there are additional restrictions affecting other SEP opportunities, in addition to those that HHS announced recently.

 

[brooks]

Client had a baby boy on January 4. She has Blue Cross Gold PPO. She had the baby at a hospital that is no longer in network for 2016.

Because she had the baby she has 60 days SEP to add her new son. She is going use her SEP to ad her son and switch to an in network BCBS Precision plan.

Her husband has a new job with group insurance effective March 1, 2016. She will be dropping BCBS at that time.

Not a bad deal. 2 months of premium for $20K in maternity benefits.

 

[AllenChicago]

That was a Smart and Savvy move on your part Brooks! Score one for consumers who use knowledgeable agents that understand the rules of Obamacare.

 

[AllenChicago]

What would you do in this hypothetical situation?

Jim just got laid off..no health insurance. He needs expensive Open Heart Surgery.

Carrier-A - Stopped paying SEP commissions

Carrier-B - Still pays 6% commissions

Both companies have a Gold plan that is identical in every way.

WHICH COMPANY DO YOU ADVISE JIM TO ENROLL WITH?

 

[cadylou]

The one you get paid for, unless there's something negative about it like provider network doesn't suit him , etc. just tell him u need to be paid if he wants someone to service any issues he may have in the future.

 

[AllenChicago]

The one you get paid for, unless there's something negative about it like provider network doesn't suit him , etc. just tell him u need to be paid if he wants someone to service any issues he may have in the future.

Are you sure, CadyLou? The company that still pays agents doesn't need or deserve this +$100,000 medical claim. You'd be biting the hand that feeds you.

But the company that stopped paying us....

 

[TN_agent]

see, and here I want to stick that enormous bill to the one that doesn't pay commission any more if all things are equal...but advise him to call the marketplace to enroll...

stick it to "the man"....

LOL

 

[AllenChicago]

see, and here I want to stick that enormous bill to the one that doesn't pay commission any more if all things are equal...but advise him to call the marketplace to enroll...

stick it to "the man"....

LOL

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haha, devious minds think alike and post at the same time apparently

Yeah boy.. I'd say we're qualified to run any of the big 3 health insurance companies!

 

[RayNY]

Thanks to the diverse reactions and perceptions of the community, we're effectively hedging against adverse selection even in light of drastic changes to our incentive to place business.

But, who am I kidding? We'll be blamed for the bad business either way...

 

[TN_agent]

True, RayNY.

But, in reality, there are rarely any plans across carriers that are 100% equal.

In the end I will try my best to advise what is best for my client.

Which is sometimes not best for my preferred carriers, financially speaking.