opinion: best catastrophic or Hospital surgical plan

PMazzapica · 08-13-2008, 05:15 PM

Wondering what everyones opinion is regarding the best hospital and surgical plan. Here in florida I would say Plan 70 with Blue cross blue shield. 80%/20% $250 deductible

robliano · 08-13-2008, 05:34 PM

If you're client can afford it, lose the co-insurance, go 100%.

myinsurebiz · 08-13-2008, 05:35 PM

In GA and SC I prefer American National for catastrophic.

103 year old company. Over 5 Million Policy Holders.

Excellent CAT and HSA.

Tom

somarco · 08-13-2008, 06:11 PM

best hospital and surgical plan

That's like asking which is better, AIDS or pancreatic cancer.

You might want to consider this. A H/S plan will cover, at best, maybe half a large claim. Maybe the BX FL plan is different, but all the ones I have seen have no coverage for outpatient expenses, including Rx not administered while an inpatient. The nominal premium savings is not worth the hassle factor when your client has a major claim and discovers they only bought half a health insurance plan.

moonlightandmargaritas · 08-13-2008, 06:57 PM

Originally Posted by PMazzapica

Wondering what everyones opinion is regarding the best hospital and surgical plan. Here in florida I would say Plan 70 with Blue cross blue shield. 80%/20% $250 deductible

Boy, if you're gettin' people involved with a $250 deductible on a hospital-surgical policy, I can't wait to get in behind you...

moonlightandmargaritas · 08-13-2008, 06:59 PM

Originally Posted by robliano

If you're client can afford it, lose the co-insurance, go 100%.

If his client can afford it, they ought to sell them REAL insurance.

robliano · 08-13-2008, 07:08 PM

Originally Posted by moonlightandmargaritas

If his client can afford it, they ought to sell them REAL insurance.

You crack me up 'tiger'

Uh oh, when you change your avatar, I'm going to look so gay, not that there's anything wrong with that, LOL.

Expat · 08-13-2008, 07:09 PM

Originally Posted by myinsurebiz

In GA and SC I prefer American National for catastrophic.

103 year old company. Over 5 Million Policy Holders.

Excellent CAT and HSA.

Tom

99% of those are small life policies. They started out as a debit company.

myinsurebiz · 08-13-2008, 07:25 PM

American National CAT plan

80/20 - $2500 Ded - $5k Stop Loss - $7mm Lifetime

Georgia - $166.34 - $246.91 with out patient

SC - $210.08 - $311.00 with out patient

( Out Patient - separate $1,000 deductible - then 80/20 up to $10k. No RX or Wellness. Pre and Post Hospital / Surgical treated as inpatient )

Golden Rule

80/20 - $2500 Ded - $15k Stop Loss - $3mm Lifetime

Georgia - $258.97 - $331.62 with out patient.

SC - $226.84 - $301.00 with out patient.

( Outpatient - no co-pays but most expenses covered 80/20 after deductible. Has RX and Wellness after deductible unless optional package is chosen - which is limited to $300 and a 12 month wait for adults with a 35% copay )

Where it makes sense - I actually steer people towards the American National CAT and attach our VIP Health Care Savings Card which has preferred rates for Dental, Vision, Hearing, RX and a $2k Accident Plan to it for $99 a month. Even includes repricing for Physicians, Hospitals, etc if better rates than the plans repricing.

If they absolutely have to have co-pays / doctors visits - I steer them towards GR or Imerica - depending on the State. Imerica has unlimited $15 doctor visit co-pays in certain states.

Tom

P.s. - the VIP Health Care Savings Card pays a direct $50 monthly commission or a $25 monthly commission and participation in a 3x3 Infinity Matrix and Matching Check Bonus.

moonlightandmargaritas · 08-13-2008, 07:31 PM

Originally Posted by myinsurebiz

Imerica has unlimited $15 doctor visit co-pays in certain states.

Until they go out of business...again...

myinsurebiz · 08-13-2008, 07:43 PM

Paul - they didn't go "out of business" - they were taken over and moved. Please show me where it states they went out of business?

Thanks,

Tom

moonlightandmargaritas · 08-13-2008, 08:02 PM

Originally Posted by myinsurebiz

Paul - they didn't go "out of business" - they were taken over and moved. Please show me where it states they went out of business?

Back in 2006, they had their "Home Office" here in Tampa (small - only about ten employees). All the admin, etc. was done by a big TPA here called HPS.

They stopped new sales, and all the employees were let go.

What do you call that?

About a year, year and a half later they had some kind of reincarnation..somewhere in Colorado?

healthagent · 08-13-2008, 08:06 PM

https://apps.tdi.state.tx.us/pcci/pc...p?tdiNum=30350

When you think if Imerica the Benny Hill theme should play in your head. I'm pretty sure I have an uncle with more money then these guys.

moonlightandmargaritas · 08-13-2008, 08:15 PM

Originally Posted by healthagent

When you think if Imerica the Benny Hill theme should play in your head. I'm pretty sure I have an uncle with more money then these guys.

3.7 million in assets at 12/31/07.

Currently redefining thinly capitalized.

moonlightandmargaritas · 08-13-2008, 08:17 PM

Originally Posted by myinsurebiz

Paul - they didn't go "out of business" - they were taken over and moved. Please show me where it states they went out of business?

Thanks,

Tom

I know you are kind of new to the business. Here's some questions you should be asking:

Are they re-insured?
By whom?
Claims north of what amount?

healthagent · 08-13-2008, 08:19 PM

...1.5 mill in premiums in TX as of Dec '07. I know a single agent who writes that amount.

robliano · 08-13-2008, 08:47 PM

The also have a ratings button and mention AMBest but when I checked AMBest can't find Imerica even listed.

That's scary!

Search Results

No Financial Strength or Issuer Credit Rated companies were found:

Criteria Used: Company Name: Company names starting with IMERICA LIFE AND HEALTH

moonlightandmargaritas · 08-13-2008, 09:06 PM

Originally Posted by robliano

The also have a ratings button and mention AMBest but when I checked AMBest can't find Imerica even listed.

An A.M. Best rating has to be purchased by the company. They may have decided to take the Home Office employees (both of them) out to lunch instead of buying one.

The company must have, I believe, at least a three year operating and financial history.

Doesn't mean much anyway, Executive Life in Los Angeles was A+ right up to the day they were seized by the California Department of Insurance in '91...

Go figure.

myinsurebiz · 08-13-2008, 09:11 PM

I haven't encountered any problems with them and they have satisfied customers - at least the ones I've called. I checked them out with a couple of doctors in an area we market - no problems. I checked with a few hospitals in the same area - no claims problems. I didn't just jump off the turnip truck.

Health is only 15% of our mix - we'll keep an eye on it - but, so far so good . . . no sense in crying the "sky is falling" just yet. We haven't written an app with them yet - waiting till the 20th for the e-app solution.

Tom

somarco · 08-13-2008, 09:25 PM

Don't recall the details, but doesn't really matter. Imerica was funded by a conglomerate of investors as I recall. European maybe? Some bank was behind them. Could have been an offshore captive even.

The carrier had never been in the health insurance business but may have been involved in special risk. Again, fuzzy on the details.

New carriers are not eligible for A M Best rating until they have been in existence for 5 years.

They had reinsurance. Seems like it was claims xs of $100k but that may not be right either.

I could never figure out why I needed an unrated carrier in my quiver. Especially one that had no experience in the health business.