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Scroll down for a discussion on Major Medical Vs Mini Plans within the Employee Benefits Forum.

Well, in Tennessee the Mini Plan won out! Governor Bredeson has effectively inacted the "Cover Tennessee" Plan using the argument that you can't force people ...


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Old 06-17-2007, 04:44 AM   #1
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Well, in Tennessee the Mini Plan won out! Governor Bredeson has effectively inacted the "Cover Tennessee" Plan using the argument that you can't force people into something they basically don't see a need for (however wrong that may be). Plus he then effectively position the argument that the majority of people in lower middle income stand a greater chance of being financially burden with medical treatment in the range of 15-25 grand then a catostropic event and cost. I think if there were more Democrats like Bredeson I would be more likely to vote Democratic.

http://www.covertn.gov/

I have to admit, I agree with Governor Bredeson.
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Old 06-17-2007, 05:00 AM   #2
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What I find interesting is that some here that scream you better have your E&O ready whenever you sell limited plans. Now you have a State that endorses the Limited Plan, I would think with that a person would have a hell of a time sueing because they brought a limited plan instead of a major plan. Of course I'm assuming that full disclosure at the time of sale.
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Old 06-17-2007, 07:43 AM   #3
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Right. It's like a bunch of new car salesman calling up a guy who has an ad in the paper for a 1988 Chevy for $1,500 and saying he's an unethical whore. You should buy a new car or take the bus.

I just sold CareFirst Personal Comp to a 45 year old smoker for $98 a month. I guess I'm going to hell, getting sued, losing my appointment and getting my license revoked because he's got a $500 cap on drugs.

But it must be a nice view from up there for some people.
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Last edited by healthagent : 06-17-2007 at 07:48 AM.
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Old 06-17-2007, 07:44 AM   #4
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There is only one reason TN (and other states such as MA) are "endorsing" the mini-med plan . . . costs.

TennCare was a comprehensive major medical plan and a financial disaster.

Already MA has scaled back what must and must not be covered under their health insurance mandate for one reason . . . costs. What was designed in the General Assembly and given an arbitrary cost figure did not hold up in the real world once the carriers were given the opportunity to price the product. The benefits were scaled back and it still did not fit. Now, with the July 1 date bearing down on them, they are back to the drawing board one more time to figure out how to provide amnesty for those who still cannot afford the new, watered down coverage.

A mini-med is like wetting the bed. It may seem right at the time but eventually you need to do something about the problem.
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Old 06-17-2007, 07:51 AM   #5
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So you're saying that when price comes into play anything is better than nothing?
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Old 06-17-2007, 11:04 AM   #6
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Originally Posted by john_petrowski View Post
So you're saying that when price comes into play anything is better than nothing?
I think most of us will agree to the above. I won't sell any of the 'basic' or 'essential' plans of the Blues (that typically have OP caps and/or limited Rx coverage) to people who can afford a better plan (ie. they live in a nice house, have a BMW, etc.) If they want a crap plan (and I them them its a crap plan) or a mini-med from NASE, I tell them to get it from someone else or go direct.

On the other hand, if I'm talking to a recent college grad looking for a job or someone recently laid off or simply someone you would classify as 'working poor' I will suggest a STM (BTW, Blue Shield of CA just pulled out of the market. Don't know why.) or a mini-med because something is better than nothing.

Personally, I think all of us who sell healthcare should be looking for a "Plan B" because other states will follow the Mass. and Tenn. leads and we're going to be cut out of the system. Myself, I do work-sups for Colonial and looking to move into the annunity senior market. Health coverage will be a 'commodity' in 36 months (one year after a new administration takes over, assuming a Dem will win, and I don't see how one can lose... if the name isn't Clinton.)

Al
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Old 06-17-2007, 11:57 AM   #7
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Al, my plan B is to continue doing what I have been doing since 1975. Write health insurance where I can and pick up the discards from agents who claim the sky is falling.

Who knows? I may even get a CA, TN & MA license just to pick up the slack when I run out of folks to sell in GA. I believe there is plenty of gold left to be mined in those areas.
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Old 06-17-2007, 01:02 PM   #8
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Originally Posted by al3 View Post
I think most of us will agree to the above. I won't sell any of the 'basic' or 'essential' plans of the Blues (that typically have OP caps and/or limited Rx coverage) to people who can afford a better plan (ie. they live in a nice house, have a BMW, etc.) If they want a crap plan (and I them them its a crap plan) or a mini-med from NASE, I tell them to get it from someone else or go direct.

On the other hand, if I'm talking to a recent college grad looking for a job or someone recently laid off or simply someone you would classify as 'working poor' I will suggest a STM (BTW, Blue Shield of CA just pulled out of the market. Don't know why.) or a mini-med because something is better than nothing.

Personally, I think all of us who sell healthcare should be looking for a "Plan B" because other states will follow the Mass. and Tenn. leads and we're going to be cut out of the system. Myself, I do work-sups for Colonial and looking to move into the annunity senior market. Health coverage will be a 'commodity' in 36 months (one year after a new administration takes over, assuming a Dem will win, and I don't see how one can lose... if the name isn't Clinton.)

Al
I do not know what's in store for individual coverage but in the very short 4 years I've been in the biz I've already seen too many negative changes. Without missing a year each year I've been in the biz since '03 rates have gone up, benefits have gone down and less and less players are in the game. Now GR is capping meds on most of their plans which doesn't bode well for the future.

The saying is expect the best but plan for the worst. I am really ramping up my business over the course of the next few years. The gravy train may stop - it may go on for another 50 years. If it goes on then great, if it stops in a few years I wouldn't mind a few hundred thou in the bank until I decide which business to get into next.
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Old 06-17-2007, 01:26 PM   #9
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Exactly, and if the @#$@ hits the fan, there is always life/disability/medicare insurance, etc.; mortgages, commercial real estate, mail order brides OR groomes, yadda yadda. Pick the niche!
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Old 06-17-2007, 01:28 PM   #10
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It makes me sick to hear about agents being cut out of the loop.
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Old 06-17-2007, 01:35 PM   #11
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Not me. Out of 100 agents selling individual health insurance I'd guess 80% of them don't know their ass from a hole in the wall. Health insurance in general would be far better off without commissioned agents. The bad majority spoil it for the few who are good.
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Old 06-17-2007, 02:34 PM   #12
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In the end I think the mini med plans will if anything give a boost to major medical. Its like the old saying, "It's easier to buy what you are familiar with then something you not familiar with". Getting more people covered and using insurance (health) will only create more interest and desire for better plans when the person is able to take advantage of better plans.
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Old 06-17-2007, 03:13 PM   #13
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Getting more people covered and using insurance (health) will only create more interest and desire for better plans when the person is able to take advantage of better plans.
Do those who buy term insurance eventually take advantage of buying perm or do they get lulled into a false sense of satisfaction until it is too late?
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Old 06-17-2007, 04:31 PM   #14
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Originally Posted by somarco View Post
Do those who buy term insurance eventually take advantage of buying perm or do they get lulled into a false sense of satisfaction until it is too late?
I would venture to say that more people that buy a perm policy has a term in place versus those that have no coverage and then going straight into a perm policy. I'm not counting Final Expense in my estimation.
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Old 06-17-2007, 05:17 PM   #15
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Possibly.

But most folks who buy mini-med never take off the training wheels and graduate to a major med.

Is mini-med better than no coverage at all? Very slightly. A mini-med will not keep you out of bankruptcy when the truck runs over you but a high deductible major med might.
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Old 06-18-2007, 12:46 AM   #16
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Originally Posted by somarco View Post
Possibly.

But most folks who buy mini-med never take off the training wheels and graduate to a major med.

Is mini-med better than no coverage at all? Very slightly. A mini-med will not keep you out of bankruptcy when the truck runs over you but a high deductible major med might.
Okay, I can go with the possible. Yet do you think that if this group of income people had no coverage would they be more likely to face financial hardship due to catostrophic or everyday medical bills? I do believe the numbers suggest that most face financial hardship over medical bills that a limited plan would pay, then those that face catostrophic type of medical bills. A family that depends upon 20-30 grand income can not pay 10 thousand dollar bill, it causes the same bankruptcy proceedings that a 100 grand plus would, that is if you could even file for bankruptcy due to medical bills today which I don't think you can now.
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Old 06-18-2007, 07:28 AM   #17
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The average person in the US who filed for BK filed for $13,000. So a very high deductible plan does not keep people out of bk. In fact over half of everyone in the US who filed for BK did so over medical claims and most already had major medical coverage. If you look at the study it also notes the people who lost coverage during the course of their illness. This study clearly indicates that "major medical" has almost no impact of keeping people out of BK.

http://www.hms.harvard.edu/news/rele...mmelstein.html
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Old 06-18-2007, 07:31 AM   #18
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The average person in the US who filed for BK filed for $13,000. So a very high deductible plan does not keep people out of bk. In fact over half of everyone in the US who filed for BK did so over medical claims and most already had major medical coverage. If you look at the study it also notes that many people who lost coverage during the course of their illness.

"Among those with private insurance, however, one-third had lost coverage at least temporarily by the time they filed for bankruptcy. Often illness led to job loss, and with it the loss of health insurance. Out-of-pocket medical costs (for co-payments, deductibles and uncovered services) averaged $13,460 for those with private insurance at the onset of their illness, vs. $10,893 for the uninsured. The highest costs -- averaging $18,005 -- were incurred by those who initially had private coverage but lost it in the course of their illness. [COLOR=Blue]Many families were bankrupted by medical expenses well below the catastrophic thresholds of high deductible plans that are increasingly popular with employers[/COLOR]. The authors comment that even their own coverage from Harvard leaves them at risk for out-of-pocket costs above levels that often led to medical bankruptcy."


http://www.hms.harvard.edu/news/rele...mmelstein.html

So you can sell very high deductible plans all day long. You're not keeping the average person from filing BK.
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Old 06-19-2007, 06:25 PM   #19
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I think DI would sure help most of those who filed for BK. Sadly, few people have DI.
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Old 06-19-2007, 06:39 PM   #20
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Agreed!

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